Provider Demographics
NPI:1013431964
Name:THOMAS, SHEILAH S MARAMARK
Entity Type:Individual
Prefix:
First Name:SHEILAH
Middle Name:S MARAMARK
Last Name:THOMAS
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 1:8787 BRANCH AVE STE 354
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2630
Mailing Address - Country:US
Mailing Address - Phone:202-236-8967
Mailing Address - Fax:301-234-6338
Practice Address - Street 1:1102 BARNABY TER SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4301
Practice Address - Country:US
Practice Address - Phone:301-297-7541
Practice Address - Fax:301-297-7541
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1612103T00000X, 103TA0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging