Provider Demographics
NPI:1225148976
Name:KAPLAN, SARITA BOBRICK (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARITA
Middle Name:BOBRICK
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SARITA
Other - Middle Name:
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1575 KINGSTREAM CIRCLE
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170
Mailing Address - Country:US
Mailing Address - Phone:703-471-6489
Mailing Address - Fax:
Practice Address - Street 1:11260 ROGER BACON DR STE 204
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5252
Practice Address - Country:US
Practice Address - Phone:703-742-8665
Practice Address - Fax:703-464-0507
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1615103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
063811OtherVALUE OPTIONS
802374Medicare ID - Type Unspecified