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Individual

SHARITA SIVELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5800 BETSY CIR, WALDORF, MD 20601-3301
(301) 609-9887
Mailing address
5800 BETSY CIR, WALDORF, MD 20601-3301
(410) 934-0581
(410) 834-1217

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LC8368
MD
101YM0800X
Mental Health Counselor
Primary
LGP6716
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
589561800
MD
Enumeration date
11/20/2015
Last updated
02/09/2023
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