MEDICARE: LETISHA TYRELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	26615	MD

General Provider Information

NPI Number	:	1235788076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LETISHA TYRELL

Provider Business Mailing Address
First Line	:	2912 GIBBONS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21214-2200
Country	:	US
Telephone Number	:	443-208-3952
Fax Number	:

Provider Business Practice Location Address
First Line	:	15480 ANNAPOLIS RD UNIT 229
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20715-1852
Country	:	US
Telephone Number	:	202-907-6515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2019
Last Update Date	:	12/17/2025

Similar Medicare Providers

1285597815 — MS. CELETTE MARSHALL LMSW
Practice Location Address:

15480 ANNAPOLIS RD
BOWIE, MD
20715-1852

Practice Phone: 240-599-3500
Practice Fax:

1457771222 — LATOYA N MCQUATER SLOAN LCPC, NCC
Practice Location Address:

15480 ANNAPOLIS RD STE 202-148
BOWIE, MD
20715-1852

Practice Phone: 240-599-3500
Practice Fax: 888-818-6466

1326426958 — GOLDEN DAYS, LLC
Practice Location Address:

15480 ANNAPOLIS RD , STE 202
BOWIE, MD
20715-1852

Practice Phone: 301-503-1490
Practice Fax:

1407209083 — DANA LAWRENCE MS, BCBA
Practice Location Address:

15480 ANNAPOLIS RD , SUITE 202 #407
BOWIE, MD
20715-1852

Practice Phone: 301-392-7075
Practice Fax:

1841736204 — HELEN CORPORAN
Practice Location Address:

15480 ANNAPOLIS RD STE RD
BOWIE, MD
20715-1852

Practice Phone: 301-392-7075
Practice Fax: 301-576-5487

1215581814 — THE MODALITIES GROUP 1 LLC
Practice Location Address:

15480 ANNAPOLIS RD STE 202-148
BOWIE, MD
20715-1852

Practice Phone: 240-599-3500
Practice Fax: 888-818-6466

Directions to “ LETISHA TYRELL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.