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Individual

MRS. ITSELDA MARIA SHAND-GAINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, LCPC

Contact information

Practice address
1629 K ST, NW, WASHINTON, DC 20006
(202) 835-0680
Mailing address
15600 TAYLERTON LN, BRANDYWINE, MD 20613-3812
(301) 922-7525

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LC5385
MD
101YP2500X
Professional Counselor
Primary
PRC14308
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LC5385
STATE LICENSE
MD
01
PRC14308
DISTRICT OF COLUMBIA LICENSE
DC
Enumeration date
12/06/2013
Last updated
07/02/2020
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