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MRS. ITSELDA MARIA SHAND-GAINES LPC, LCPC
Professional >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1992136592
Individual Registrant:MRS. ITSELDA MARIA SHAND-GAINES LPC, LCPC
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
1629 K ST, NW WASHINTON, DC 20006 US
Tel: 202-835-0680 Fax: --
Tel: 202-835-0680 Fax: --
Contact information for business:
15600 TAYLERTON LN BRANDYWINE, MD 20613-3812 US
Tel: 301-922-7525 Fax: --
Tel: 301-922-7525 Fax: --
Registration Information:
NPI: 1992136592
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor Professional | DC | PRC14308 |
| N | 101YP2500X | Behavioral Health & Social Service Providers Counselor | MD | LC5385 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| DISTRICT OF COLUMBIA LICENSE | PRC14308 | DC | 01 |
| STATE LICENSE | LC5385 | MD | 01 |
