Provider Demographics
NPI:1568845964
Name:MYLAN, SANAA E (LCPC, LMHC, MS)
Entity Type:Individual
Prefix:
First Name:SANAA
Middle Name:E
Last Name:MYLAN
Suffix:
Gender:F
Credentials:LCPC, LMHC, MS
Other - Prefix:
Other - First Name:SANA
Other - Middle Name:
Other - Last Name:AWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13614 TREE LEAF CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4205
Mailing Address - Country:US
Mailing Address - Phone:718-805-4719
Mailing Address - Fax:
Practice Address - Street 1:590 6TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2022
Practice Address - Country:US
Practice Address - Phone:646-874-4886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC9949101YP2500X
NY008090101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional