Provider Demographics
NPI:1750964987
Name:HUSSEIN, TAMASHA
Entity type:Individual
Prefix:
First Name:TAMASHA
Middle Name:
Last Name:HUSSEIN
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:SECOND FLOOR, 111 CENTERWAY SUITE C
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2116
Mailing Address - Country:US
Mailing Address - Phone:240-670-4050
Mailing Address - Fax:
Practice Address - Street 1:111 CENTERWAY STE C2
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1808
Practice Address - Country:US
Practice Address - Phone:240-670-4050
Practice Address - Fax:240-201-2660
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2023-09-14
Deactivation Date:2022-08-02
Deactivation Code:
Reactivation Date:2023-08-31
Provider Licenses
StateLicense IDTaxonomies
MD30301101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health