Provider Demographics
NPI:1962398826
Name:RAO, ANISHA SARAH (LGPC)
Entity type:Individual
Prefix:
First Name:ANISHA
Middle Name:SARAH
Last Name:RAO
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6809 IRONBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-9510
Mailing Address - Country:US
Mailing Address - Phone:437-607-6734
Mailing Address - Fax:
Practice Address - Street 1:8713 GRANITE LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2435
Practice Address - Country:US
Practice Address - Phone:410-961-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP16347101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional