Provider Demographics
NPI:1972784627
Name:SINGHA, SUMAN
Entity type:Individual
Prefix:
First Name:SUMAN
Middle Name:
Last Name:SINGHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11387 COURTHOUSE ROAD
Mailing Address - Street 2:
Mailing Address - City:LUNENBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23952
Mailing Address - Country:US
Mailing Address - Phone:434-696-3747
Mailing Address - Fax:434-392-1753
Practice Address - Street 1:11387 COURTHOUSE ROAD
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:VA
Practice Address - Zip Code:23952
Practice Address - Country:US
Practice Address - Phone:434-696-3747
Practice Address - Fax:434-696-1753
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004262101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health