Provider Demographics
NPI:1609945583
Name:HORWATT, SALLY SINGER (PHD)
Entity Type:Individual
Prefix:DR
First Name:SALLY
Middle Name:SINGER
Last Name:HORWATT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:SALLY
Other - Middle Name:SINGER
Other - Last Name:BRODSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1800 TOWN CENTER DRIVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3238
Mailing Address - Country:US
Mailing Address - Phone:703-435-4741
Mailing Address - Fax:703-435-5881
Practice Address - Street 1:1800 TOWN CENTER DR
Practice Address - Street 2:SUITE 216
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3238
Practice Address - Country:US
Practice Address - Phone:703-435-4741
Practice Address - Fax:703-435-5881
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000918103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA73747596OtherUNITED BEHAVIORAL HEALTH
VA4602666OtherAETNA
DCB386OtherGHMSI
VA435492Medicare ID - Type Unspecified