Radiance Allen Sanneman, MS, LPC, NCC, CCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC12394 Issued in MD

Practice address

8507 Oxon Hill Rd Ste 200
Fort Washington, MD 20744-4774

Phone

(301) 246-0074

NPI assigned

Apr 14, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mr. Peter Allen Sanneman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 27, 2024 through Mar 27, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1124647615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8507 OXON HILL RD STE 200",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207444774",
            "telephone_number": "301-246-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 OXON HILL RD STE 200",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207444774",
            "telephone_number": "301-246-0074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 S Whiting St Ste 318",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223043416",
            "country_code": "US",
            "telephone_number": "703-249-9735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANNEMAN",
        "first_name": "RADIANCE",
        "middle_name": "ALLEN",
        "name_prefix": "Ms.",
        "credential": "MS, LPC, NCC, CCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701011435",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "PRC200001455",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC12394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PETER",
            "last_name": "SANNEMAN",
            "middle_name": "ALLEN",
            "prefix": "MR.",
            "credential": "MS, LPC, NCC, CCMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Saint Pharmacy, Inc
• Sameer B. Shammas, MD, PC
• Eleanor Santos Sampilo, RN
• Keith Ladsen Sanders, M.D.
• Sanjiv Bhatia DDS PC
• Monica Denise Saunders
• Denise Collette Savage, JD
• Stephanie Scates, MSW
• Everett N Scott, DC
• Serene Minds Behavioral Health Services LLC

• Mental Health Counselor in Fort Washington, MD
• Providers in Fort Washington, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.