Provider Demographics
NPI:1861825424
Name:LAURICE, SHERVON (MS, LCPC, LPC)
Entity Type:Individual
Prefix:
First Name:SHERVON
Middle Name:
Last Name:LAURICE
Suffix:
Gender:F
Credentials:MS, LCPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E WEST HWY
Mailing Address - Street 2:SUITE 1003
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 E WEST HWY APT 1003
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3260
Practice Address - Country:US
Practice Address - Phone:301-873-4457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-18
Last Update Date:2015-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2043101YP2500X
DCPRC14347101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional