Provider Demographics
NPI:1447386727
Name:MARDIGIAN, BARBARA R (LPC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:R
Last Name:MARDIGIAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 RADFORD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3512
Mailing Address - Country:US
Mailing Address - Phone:804-354-1996
Mailing Address - Fax:804-354-5516
Practice Address - Street 1:4906 RADFORD AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3512
Practice Address - Country:US
Practice Address - Phone:804-354-1996
Practice Address - Fax:804-354-5516
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003649101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA083788MOtherSENTARA
VA174939OtherANTHEM
VA4945131OtherVIRGINIA PREMIER