Provider Demographics
NPI:1245906817
Name:NGASHU, LAWRENCE (LCPC)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:NGASHU
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10935 SASSAN LN
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-4070
Mailing Address - Country:US
Mailing Address - Phone:240-746-5141
Mailing Address - Fax:410-780-5205
Practice Address - Street 1:9627 PHILADELPHIA RD STE 160
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4157
Practice Address - Country:US
Practice Address - Phone:410-780-5203
Practice Address - Fax:410-780-5205
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC12846101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health