Provider Demographics
NPI:1508020454
Name:ENDURING CONNECTIONS, PLC
Entity Type:Organization
Organization Name:ENDURING CONNECTIONS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-865-8880
Mailing Address - Street 1:3611 CHAIN BRIDGE RD STE D
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3246
Mailing Address - Country:US
Mailing Address - Phone:703-865-8880
Mailing Address - Fax:703-865-8891
Practice Address - Street 1:3611 CHAIN BRIDGE RD STE D
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3246
Practice Address - Country:US
Practice Address - Phone:703-865-8880
Practice Address - Fax:703-865-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040062051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1508020454Medicaid
VA354934OtherANTHEM BLUE CROSS AND BLUE SHIELD