Provider Demographics
NPI:1912170101
Name:SPEIGHT, NATOSHA PETERSON (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:NATOSHA
Middle Name:PETERSON
Last Name:SPEIGHT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 ORA LEA LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-6040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7801 OLD BRANCH AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1608
Practice Address - Country:US
Practice Address - Phone:301-856-8516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC103TS0200X
MD134941041C0700X
DCLC500783111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool