Individual provider Active NPI

Sharilyn Denise Connally, LGPC

  • Professional Counselor
  • Lanham, MD
National Provider Identifier
1043469430
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LGP294 Issued in MD
Practice address
9320 Annapolis Rd Ste 100
Lanham, MD 20706-3122
Phone
(301) 577-8152
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LGP294 MD Primary

Addresses

Primary practice location

9320 Annapolis Rd Ste 100
Lanham, MD 20706-3122

Mailing address

12100 Sand Wedge LN
Upper Marlboro, MD 20772-7965
Phone (240) 244-1787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250131002319 DC Practitioner - Mental Health Counselor 7517496722 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGP294MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Professional CurrentSince Nov 29, 2024 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Nov 29, 2024 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Vesta Inc Past Accepting new patients

Locations

2000 Medical Pkwy
Ste 409
Annapolis, MD 21401
Phone (443) 481-5136

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1043469430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 SAND WEDGE LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207727965",
            "telephone_number": "240-244-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 ANNAPOLIS RD STE 100",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063122",
            "telephone_number": "301-577-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNALLY",
        "first_name": "SHARILYN",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "LGPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

Verify at the official NPI Registry.