Healthcare Provider Details

I. General information

NPI: 1760982987
Provider Name (Legal Business Name): SURESH LAMA TAMANG LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2018
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5020 QUEENSBURY CIR
FREDERICKSBURG VA
22408-1818
US

IV. Provider business mailing address

5020 QUEENSBURY CIR
FREDERICKSBURG VA
22408-1818
US

V. Phone/Fax

Practice location:
  • Phone: 703-986-7937
  • Fax:
Mailing address:
  • Phone: 703-986-7937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701015196
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: