Healthcare Provider Details

I. General information

NPI: 1801542766
Provider Name (Legal Business Name): LETISHA MICHAELA APPOLLO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LETISHA MICHAELA HENRY LMSW

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 HARFORD RD
BALTIMORE MD
21214-3116
US

IV. Provider business mailing address

4308 HARFORD RD
BALTIMORE MD
21214-3116
US

V. Phone/Fax

Practice location:
  • Phone: 410-426-5650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34804
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: