Provider Demographics
NPI:1598214900
Name:LISA FLEMING, LPC, LLC
Entity Type:Organization
Organization Name:LISA FLEMING, LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:540-907-2066
Mailing Address - Street 1:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:THORNBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22565-0124
Mailing Address - Country:US
Mailing Address - Phone:540-907-2066
Mailing Address - Fax:
Practice Address - Street 1:2217 PRINCESS ANNE ST
Practice Address - Street 2:SUITE B10
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3353
Practice Address - Country:US
Practice Address - Phone:540-907-2066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005409101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty