Provider Demographics
NPI:1700411865
Name:OSBOURNE, SHEILA (LCPC)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:OSBOURNE
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 1:4901 GALLATIN ST
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-2338
Mailing Address - Country:US
Mailing Address - Phone:240-481-1110
Mailing Address - Fax:
Practice Address - Street 1:6201 GREENBELT RD STE L4
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2357
Practice Address - Country:US
Practice Address - Phone:240-481-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10059101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health