Provider Demographics
NPI:1992902001
Name:LANDSMAN, IRENE SMITH (PHD)
Entity type:Individual
Prefix:DR
First Name:IRENE
Middle Name:SMITH
Last Name:LANDSMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7910 WOODMONT AVE
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3002
Mailing Address - Country:US
Mailing Address - Phone:301-656-8020
Mailing Address - Fax:
Practice Address - Street 1:7910 WOODMONT AVE
Practice Address - Street 2:SUITE 1101
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3002
Practice Address - Country:US
Practice Address - Phone:301-656-8020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03097103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLA901427Medicare ID - Type Unspecified