Provider Demographics
NPI:1417256579
Name:SHARNOUBI, SANAA (LCPC)
Entity Type:Individual
Prefix:
First Name:SANAA
Middle Name:
Last Name:SHARNOUBI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2315
Mailing Address - Country:US
Mailing Address - Phone:301-910-2965
Mailing Address - Fax:301-424-1170
Practice Address - Street 1:122 EVANS ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2817
Practice Address - Country:US
Practice Address - Phone:301-910-2965
Practice Address - Fax:301-424-1170
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2190101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional