Provider Demographics
NPI:1699125930
Name:DECAMP, ASHLEY (PSYD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DECAMP
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 1:21001 SYCOLIN RD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4073
Mailing Address - Country:US
Mailing Address - Phone:703-858-7838
Mailing Address - Fax:
Practice Address - Street 1:21001 SYCOLIN RD
Practice Address - Street 2:SUITE 360
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4073
Practice Address - Country:US
Practice Address - Phone:703-858-7838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005448103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical