Provider Demographics
NPI:1639615826
Name:LOFTIS, CHRIS (PHD, PMP)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:LOFTIS
Suffix:
Gender:M
Credentials:PHD, PMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9480 MAIN ST # 1018
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4032
Mailing Address - Country:US
Mailing Address - Phone:703-519-6186
Mailing Address - Fax:
Practice Address - Street 1:4250 N. FAIRFAX DRIVE
Practice Address - Street 2:SUITE 600 #4777
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203
Practice Address - Country:US
Practice Address - Phone:202-681-5357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-11
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPSY1000527103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist