Provider Demographics
NPI:1730434556
Name:ADAM J. SOWA, PH.D., LLC
Entity type:Organization
Organization Name:ADAM J. SOWA, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOWA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-321-4886
Mailing Address - Street 1:5680 RAVENEL LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-2431
Mailing Address - Country:US
Mailing Address - Phone:703-321-4886
Mailing Address - Fax:703-321-4886
Practice Address - Street 1:8720 GEORGIA AVE
Practice Address - Street 2:SUITE #300
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3638
Practice Address - Country:US
Practice Address - Phone:301-565-0534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04138103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty