Provider Demographics
NPI:1619338050
Name:DOGALI, LINDSEY MICHELLE CAPON (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:MICHELLE CAPON
Last Name:DOGALI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7207 STATECREST DR
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-1644
Mailing Address - Country:US
Mailing Address - Phone:301-509-6022
Mailing Address - Fax:
Practice Address - Street 1:7207 STATECREST DR
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-1644
Practice Address - Country:US
Practice Address - Phone:301-509-6022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-13
Last Update Date:2016-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005349103TB0200X, 103TC2200X
MD05658103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical