Provider Demographics
NPI:1922301423
Name:MADHOSINGH, SAMANTHA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:
Last Name:MADHOSINGH
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 1:1934 OLD GALLOWS RD
Mailing Address - Street 2:350
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-4042
Mailing Address - Country:US
Mailing Address - Phone:703-717-5060
Mailing Address - Fax:703-652-8326
Practice Address - Street 1:1934 OLD GALLOWS RD
Practice Address - Street 2:350
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-4042
Practice Address - Country:US
Practice Address - Phone:703-717-5060
Practice Address - Fax:703-652-8326
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003364103TC0700X
DCPSY1000235103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical