Provider Demographics
NPI:1568558450
Name:ROSEN, LAURIE LERNER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:LERNER
Last Name:ROSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10609 BATTALION LANDING CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2517
Mailing Address - Country:US
Mailing Address - Phone:703-321-0098
Mailing Address - Fax:703-239-2600
Practice Address - Street 1:10470 ARMSTRONG ST
Practice Address - Street 2:COUNSELING CENTER OF FAIRFAX
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3648
Practice Address - Country:US
Practice Address - Phone:703-239-2600
Practice Address - Fax:703-385-7578
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040029461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical