Provider Demographics
NPI:1750377156
Name:ADAMO, SONYA (PSYD)
Entity type:Individual
Prefix:DR
First Name:SONYA
Middle Name:
Last Name:ADAMO
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 1:14440 CHERRY LANE CT
Mailing Address - Street 2:#203
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4946
Mailing Address - Country:US
Mailing Address - Phone:301-776-8080
Mailing Address - Fax:301-920-1929
Practice Address - Street 1:14440 CHERRY LANE CT
Practice Address - Street 2:#203
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4946
Practice Address - Country:US
Practice Address - Phone:301-776-8080
Practice Address - Fax:301-920-1929
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03611103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD767200400Medicaid
MD490923Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST