Provider Demographics
NPI:1053040907
Name:ANTHONY, SHEENA (MA, LGPC)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:MA, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9741 COUNTRY MEADOWS LN APT 3A
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-6310
Mailing Address - Country:US
Mailing Address - Phone:516-325-4240
Mailing Address - Fax:
Practice Address - Street 1:7533 MAIN ST STE 1F
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-5308
Practice Address - Country:US
Practice Address - Phone:516-325-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP12717101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional