Provider Demographics
NPI:1417749169
Name:ADDY, ABIGAIL ARABA (LCPC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ARABA
Last Name:ADDY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20225 HALETHORPE LN APT 13
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-5712
Mailing Address - Country:US
Mailing Address - Phone:240-386-9400
Mailing Address - Fax:
Practice Address - Street 1:20225 HALETHORPE LN APT 13
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-5712
Practice Address - Country:US
Practice Address - Phone:240-386-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC16292101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty