Healthcare Provider Details

I. General information

NPI: 1144898081
Provider Name (Legal Business Name): JULIET ENOH-ROLAND LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 JEFFERSON ST
LANHAM MD
20706-4204
US

IV. Provider business mailing address

4810 JEFFERSON ST
LANHAM MD
20706-4204
US

V. Phone/Fax

Practice location:
  • Phone: 813-606-9142
  • Fax:
Mailing address:
  • Phone: 813-606-9142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC11173
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: