Active NPI
Shelly De Silva
- Mental Health Counselor
- Lanham, MD
National Provider Identifier
1629746110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LGP11845
- Practice address
- 4601 Presidents Dr Ste 135
Lanham, MD 20706-4894 - Phone
- (240) 473-3404
- NPI assigned
- Aug 31, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LGP11845 | MD | Primary |
Addresses
Primary practice location
4601 Presidents Dr Ste 135
Lanham, MD 20706-4894
Mailing address
4211 Russell Ave Apt 2
Mount Rainier, MD 20712-1724
Phone (848) 391-6664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGP11845 | MD | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1629746110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4211 RUSSELL AVE APT 2",
"city": "MOUNT RAINIER",
"state": "MD",
"postal_code": "207121724",
"telephone_number": "848-391-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 PRESIDENTS DR STE 135",
"city": "LANHAM",
"state": "MD",
"postal_code": "207064894",
"telephone_number": "240-473-3404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE SILVA",
"first_name": "SHELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-31",
"last_updated": "2021-08-31",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "LGP11845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lanham, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.