Provider Demographics
NPI:1073611935
Name:PRICE, DONNA L (LPC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPC
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Other - Last Name:
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Mailing Address - Street 1:2239F TACKETTS MILL DR
Mailing Address - Street 2:PSYCHOLOGICAL & LIFE SKILLS ASSOC PC
Mailing Address - City:LAKE RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192
Mailing Address - Country:US
Mailing Address - Phone:703-490-0336
Mailing Address - Fax:703-490-4525
Practice Address - Street 1:2239F TACKETTS MILL DR
Practice Address - Street 2:PSYCHOLOGICAL & LIFE SKILLS ASSOC PC
Practice Address - City:LAKE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192
Practice Address - Country:US
Practice Address - Phone:703-490-0336
Practice Address - Fax:703-490-4525
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0701003150103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA227507OtherKAISER
VA23570015OtherCAREFIRST
VA275695OtherANTHEM BCBS