Provider Demographics
NPI:1649533464
Name:DAS, AMY LAZAROV (MED, LPC-MHSP, NCC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LAZAROV
Last Name:DAS
Suffix:
Gender:F
Credentials:MED, LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CHAPMAN AVE APT 549
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1995
Mailing Address - Country:US
Mailing Address - Phone:615-762-6629
Mailing Address - Fax:
Practice Address - Street 1:1900 CHAPMAN AVE APT 549
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1995
Practice Address - Country:US
Practice Address - Phone:615-762-6629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health