Provider Demographics
NPI:1477582294
Name:BRANCATO, LINDSAY BENEDICT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:BENEDICT
Last Name:BRANCATO
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 1:5480 WISCONSIN AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3524
Mailing Address - Country:US
Mailing Address - Phone:202-270-2370
Mailing Address - Fax:
Practice Address - Street 1:5480 WISCONSIN AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3530
Practice Address - Country:US
Practice Address - Phone:202-270-2370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04332103TC0700X
MD102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
204536283OtherEIN