Provider Demographics
NPI:1225781735
Name:QASSEM, ESSAM SAID (LGPC)
Entity Type:Individual
Prefix:
First Name:ESSAM
Middle Name:SAID
Last Name:QASSEM
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6938 SEVEN LOCKS RD
Mailing Address - Street 2:
Mailing Address - City:CABIN JOHN
Mailing Address - State:MD
Mailing Address - Zip Code:20818-1101
Mailing Address - Country:US
Mailing Address - Phone:301-802-4591
Mailing Address - Fax:
Practice Address - Street 1:230 N WASHINGTON ST STE 402
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1780
Practice Address - Country:US
Practice Address - Phone:301-922-5759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11981101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty