Provider Demographics
NPI:1821460635
Name:SEBIAN-LANDER, TIM AARON (MS, LGPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:TIM
Middle Name:AARON
Last Name:SEBIAN-LANDER
Suffix:
Gender:M
Credentials:MS, LGPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 33RD ST
Mailing Address - Street 2:APT#24
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-2020
Mailing Address - Country:US
Mailing Address - Phone:410-474-5934
Mailing Address - Fax:
Practice Address - Street 1:3801 33RD ST
Practice Address - Street 2:APT#24
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-2020
Practice Address - Country:US
Practice Address - Phone:410-474-5934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP6658101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional