Provider Demographics
NPI:1437480589
Name:LEE, LISA FRAILING (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:FRAILING
Last Name:LEE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:FRAILING
Other - Last Name:RANDLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:287 INDEPENDENCE BLVD
Mailing Address - Street 2:PEMBROKE 2, SUITE 219
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-2962
Mailing Address - Country:US
Mailing Address - Phone:757-490-6960
Mailing Address - Fax:757-490-6995
Practice Address - Street 1:287 INDEPENDENCE BLVD
Practice Address - Street 2:PEMBROKE 2, SUITE 219
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2962
Practice Address - Country:US
Practice Address - Phone:757-490-6960
Practice Address - Fax:757-490-6995
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004757101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional