Provider Demographics
NPI:1538036330
Name:SHEETZ, RAQUEL LAUREN
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:LAUREN
Last Name:SHEETZ
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 1:14708 PEBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-5844
Mailing Address - Country:US
Mailing Address - Phone:267-221-9698
Mailing Address - Fax:
Practice Address - Street 1:14708 PEBBLESTONE DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905-5844
Practice Address - Country:US
Practice Address - Phone:267-221-9698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30613103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool