Provider Demographics
NPI:1780579300
Name:SASEENDRANATH, DIVYADHARSHINI
Entity type:Individual
Prefix:MS
First Name:DIVYADHARSHINI
Middle Name:
Last Name:SASEENDRANATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ROBERT ST APT 7
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-3954
Mailing Address - Country:US
Mailing Address - Phone:667-899-8285
Mailing Address - Fax:
Practice Address - Street 1:675 SEAWAVE CT
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-2379
Practice Address - Country:US
Practice Address - Phone:410-604-8776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP16572101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health