Provider Demographics
NPI:1700664034
Name:DILLMAN HENRY, SLOAN MICHELLE (LCPC)
Entity Type:Individual
Prefix:
First Name:SLOAN
Middle Name:MICHELLE
Last Name:DILLMAN HENRY
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 1:515 BOISSEVAIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-2107
Mailing Address - Country:US
Mailing Address - Phone:864-903-9119
Mailing Address - Fax:
Practice Address - Street 1:898 AIRPORT PARK RD
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2558
Practice Address - Country:US
Practice Address - Phone:410-870-7036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC13988101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional