Provider Demographics
NPI:1205375284
Name:PENDLETON, TYMESHA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TYMESHA
Middle Name:
Last Name:PENDLETON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:T.
Other - Middle Name:ANTONIA
Other - Last Name:PENDLETON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 73188
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20056-3188
Mailing Address - Country:US
Mailing Address - Phone:202-341-0500
Mailing Address - Fax:
Practice Address - Street 1:8501 COLESVILLE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3322
Practice Address - Country:US
Practice Address - Phone:202-341-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA0182101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health