Provider Demographics
NPI:1730392168
Name:DUCHESNEAU, SHARON (MA, LCPC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:DUCHESNEAU
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11110 WHISPERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:N BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3668
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11110 WHISPERWOOD LN
Practice Address - Street 2:
Practice Address - City:N BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-3668
Practice Address - Country:US
Practice Address - Phone:301-493-6044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC 1396101YM0800X
DCPRC 13804101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
J4880002OtherBCBS