Healthcare Provider Details

I. General information

NPI: 1679404842
Provider Name (Legal Business Name): LASHANA MARTINEZ PSYD, LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LASHANA LEWIS PSYD, LGPC

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 TIDEWATER COLONY DR STE 1A
ANNAPOLIS MD
21401-2102
US

IV. Provider business mailing address

7902 CHAPEL COVE DR
LAUREL MD
20707-5842
US

V. Phone/Fax

Practice location:
  • Phone: 410-648-9773
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP17863
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: