MEDICARE: SEQUOIA HENSON LCPC

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	101YP2500X	Professional Counselor	LC4670	MD
2	101YP2500X	Professional Counselor	LGPC2860	MD

General Provider Information

NPI Number	:	1356583744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEQUOIA HENSON LCPC

Provider Business Mailing Address
First Line	:	4709 HARFORD RD STE A-66
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21214-3205
Country	:	US
Telephone Number	:	410-491-4762
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 N HOWARD ST STE 300
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21218-5909
Country	:	US
Telephone Number	:	443-438-6742
Fax Number	:

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

Provider Enumeration Date	:	03/31/2009
Last Update Date	:	12/31/2025

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