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General NPI Number Information
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NPI Number | 1710060579
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Entity Type | Individual
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Provider Name | SHEILA MARIE HOUGHTON-ANTONUCCI LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 11/12/2023
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Provider Practice Location Address
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Address Line | 8091 WISCONSIN AVENUE
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City | BETHESDA
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State | MD
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Zip | 20889-3348
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Country | US
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Telephone | 301-319-7981
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Fax |
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Provider Business Mailing Address
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Address Line | 805 RESERVE CHAMPION DR APT 102
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City | ROCKVILLE
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State | MD
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Zip | 20850-6646
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Country | US
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Telephone | 412-889-0994
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW013896
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License Number State | PA
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