Provider Demographics
NPI:1497520746
Name:FIELDS, LISA M (LCSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:M
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GARFIELD ELEMENTARY SCHOOL
Mailing Address - Street 2:7101 OLD KEENE MILL ROAD
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150
Mailing Address - Country:US
Mailing Address - Phone:703-923-2900
Mailing Address - Fax:
Practice Address - Street 1:GARFIELD ELEMENTARY SCHOOL
Practice Address - Street 2:7101 OLD KEENE MILL ROAD
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150
Practice Address - Country:US
Practice Address - Phone:703-923-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040145501041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool