Provider Demographics
NPI:1982998910
Name:SMITH, BARBARA G (PHD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:G
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:JEAN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3900 JERMANTOWN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4900
Mailing Address - Country:US
Mailing Address - Phone:703-574-0012
Mailing Address - Fax:571-266-5538
Practice Address - Street 1:3900 JERMANTOWN RD STE 300
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4900
Practice Address - Country:US
Practice Address - Phone:703-574-0012
Practice Address - Fax:571-266-5548
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004420103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist