Individual
DR. SHAUNA MOORE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D., NCC,LPC, LCPC
Contact information
Practice address
11785 BELTSVILLE DR STE 120, CALVERTON, MD 20705-3121
(240) 389-1487
(240) 389-1463
Mailing address
PO BOX 275, BURTONSVILLE, MD 20866-0275
(240) 389-1487
(240) 389-1463
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC4866
MD
101Y00000X
Counselor
PCR14291
DC
101YM0800X
Mental Health Counselor
LC4866
MD
101YM0800X
Mental Health Counselor
PCR14291
DC
101YP2500X
Professional Counselor
Primary
LC4866
MD
101YP2500X
Professional Counselor
PRC14291
DC
106H00000X
Marriage & Family Therapist
LC4866
MD
106H00000X
Marriage & Family Therapist
PCR14291
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0647632P0000
—
MD
Enumeration date
07/31/2012
Last updated
02/07/2024
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