Provider Demographics
NPI:1417511411
Name:LEPAGE, ABBY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ABBY
Middle Name:
Last Name:LEPAGE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 22ND ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1217
Mailing Address - Country:US
Mailing Address - Phone:202-681-9716
Mailing Address - Fax:
Practice Address - Street 1:2000 P ST NW STE 603
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6970
Practice Address - Country:US
Practice Address - Phone:202-681-9716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810006176103TC0700X
DCPSY1001595103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical