Provider Demographics
NPI:1417270992
Name:CARRICK, LORI WILLIAMSON (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:WILLIAMSON
Last Name:CARRICK
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 ALLERDALE CT
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-2777
Mailing Address - Country:US
Mailing Address - Phone:703-489-3561
Mailing Address - Fax:703-690-0010
Practice Address - Street 1:8301 ALLERDALE CT
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-2777
Practice Address - Country:US
Practice Address - Phone:703-489-3561
Practice Address - Fax:703-690-0010
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14073101YP2500X
VA0701004813101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional