Provider Demographics
NPI:1407626740
Name:LITI, ANDI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDI
Middle Name:
Last Name:LITI
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 1:2819 TOLES PARK DR
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-1611
Mailing Address - Country:US
Mailing Address - Phone:301-655-4029
Mailing Address - Fax:
Practice Address - Street 1:2819 TOLES PARK DR
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-1611
Practice Address - Country:US
Practice Address - Phone:301-655-4029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008389103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical