Provider Demographics
NPI:1508876426
Name:LAGER PSYCHOLOGICAL SVCS
Entity Type:Organization
Organization Name:LAGER PSYCHOLOGICAL SVCS
Other - Org Name:JENNIFER LAGER PSYD
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:703-356-5534
Mailing Address - Street 1:6832 OLD DOMINION DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101
Mailing Address - Country:US
Mailing Address - Phone:703-244-9656
Mailing Address - Fax:703-734-0910
Practice Address - Street 1:6832 OLD DOMINION DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101
Practice Address - Country:US
Practice Address - Phone:703-244-9656
Practice Address - Fax:703-734-0910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X
VA0810002692103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF538OtherBLUE CROSS BLUE SHIELD