Provider Demographics
NPI:1689723405
Name:PAISLET, JACALYN ROBIN (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:JACALYN
Middle Name:ROBIN
Last Name:PAISLET
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 CARLISLE DR STE B
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4897
Mailing Address - Country:US
Mailing Address - Phone:703-476-3899
Mailing Address - Fax:
Practice Address - Street 1:489 CARLISLE DR STE B
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4897
Practice Address - Country:US
Practice Address - Phone:703-476-3899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001499101YP2500X
VA0717000614106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist