Healthcare Provider Details

I. General information

NPI: 1467912964
Provider Name (Legal Business Name): SUCHITA PALIT MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21155 WHITFIELD PL STE 202
STERLING VA
20165-7277
US

IV. Provider business mailing address

24645 KINGS CANYON SQ
STONE RIDGE VA
20105-2987
US

V. Phone/Fax

Practice location:
  • Phone: 571-446-0010
  • Fax:
Mailing address:
  • Phone: 484-744-0577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: