Provider Demographics
NPI:1417608894
Name:TSEGAYE, HERMELA (LGPC)
Entity Type:Individual
Prefix:MRS
First Name:HERMELA
Middle Name:
Last Name:TSEGAYE
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13612 COLGATE WAY APT 445
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7224
Mailing Address - Country:US
Mailing Address - Phone:240-620-1856
Mailing Address - Fax:
Practice Address - Street 1:17 WARREN RD STE 1A
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5001
Practice Address - Country:US
Practice Address - Phone:410-989-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP12028101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health