Healthcare Provider Details

I. General information

NPI: 1588107577
Provider Name (Legal Business Name): SIOBHAN NINE LCPC (MD)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2016
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9466 GEORGIA AVE # 1169
SILVER SPRING MD
20910-1456
US

IV. Provider business mailing address

9466 GEORGIA AVE # 1169
SILVER SPRING MD
20910-1456
US

V. Phone/Fax

Practice location:
  • Phone: 443-446-4721
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC22164
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC16625
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number68200
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: