Provider Demographics
NPI:1407018831
Name:PERSAUD, AINISHA BIKIRA (LCMFT)
Entity Type:Individual
Prefix:MRS
First Name:AINISHA
Middle Name:BIKIRA
Last Name:PERSAUD
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 MERCANTILE LN
Mailing Address - Street 2:SUITE 126-A
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5327
Mailing Address - Country:US
Mailing Address - Phone:301-772-8284
Mailing Address - Fax:301-805-7015
Practice Address - Street 1:1300 MERCANTILE LN
Practice Address - Street 2:SUITE 126-A
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5327
Practice Address - Country:US
Practice Address - Phone:301-772-8284
Practice Address - Fax:301-805-7015
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM178106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist