Provider Demographics
NPI:1316024144
Name:MILGRIM, STEVEN PHILLIP (LPC, LSATP)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:PHILLIP
Last Name:MILGRIM
Suffix:
Gender:M
Credentials:LPC, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6296
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22195-6296
Mailing Address - Country:US
Mailing Address - Phone:703-499-9889
Mailing Address - Fax:703-499-9889
Practice Address - Street 1:12584 DARBY BROOK CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2485
Practice Address - Country:US
Practice Address - Phone:703-499-9889
Practice Address - Fax:703-499-9889
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000089101YA0400X
VA0701003080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional