Provider Demographics
NPI:1609644186
Name:KATIKINENI, SHEELA
Entity Type:Individual
Prefix:MRS
First Name:SHEELA
Middle Name:
Last Name:KATIKINENI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 NIGHTSHADE CT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3409
Mailing Address - Country:US
Mailing Address - Phone:240-731-9616
Mailing Address - Fax:
Practice Address - Street 1:9420 KEY WEST AVE STE 430
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6371
Practice Address - Country:US
Practice Address - Phone:301-579-0089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14423101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health