Provider Demographics
NPI:1760675581
Name:SHOULDERS, ROSHANDA L (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSHANDA
Middle Name:L
Last Name:SHOULDERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5512 CEDAR GROVE DRIVE
Mailing Address - Street 2:232
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-5341
Mailing Address - Country:US
Mailing Address - Phone:203-537-1785
Mailing Address - Fax:203-537-1785
Practice Address - Street 1:5512 CEDAR GROVE DRIVE
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-2077
Practice Address - Country:US
Practice Address - Phone:203-537-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MDG12751104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical