Provider Demographics
NPI:1861850836
Name:PREMPEH, HENRY (PHD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:PREMPEH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 FORT MYER DR STE 350
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-3118
Mailing Address - Country:US
Mailing Address - Phone:202-780-6103
Mailing Address - Fax:
Practice Address - Street 1:1655 FORT MYER DR STE 350
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209-3118
Practice Address - Country:US
Practice Address - Phone:202-780-6103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1001119103TC0700X
VA0810005641103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical