Provider Demographics
NPI:1194846105
Name:FLEMING, MATTHEW DANG (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DANG
Last Name:FLEMING
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4657 KINSEY LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-4916
Mailing Address - Country:US
Mailing Address - Phone:703-304-7082
Mailing Address - Fax:
Practice Address - Street 1:1700 CONNECTICUT AVE NW STE 401
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1169
Practice Address - Country:US
Practice Address - Phone:703-304-7082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000378101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health