Provider Demographics
NPI:1629782370
Name:LANSDOWNE MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:LANSDOWNE MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANGEETA
Authorized Official - Middle Name:REEDDY
Authorized Official - Last Name:CHITLU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-585-9524
Mailing Address - Street 1:44169 RIVERPOINT DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8207
Mailing Address - Country:US
Mailing Address - Phone:703-585-9524
Mailing Address - Fax:
Practice Address - Street 1:44169 RIVERPOINT DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8207
Practice Address - Country:US
Practice Address - Phone:703-585-9524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAFC1545915OtherDEA