Provider Demographics
NPI:1760468144
Name:LAFAVE, LINDA MARY (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARY
Last Name:LAFAVE
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 1:2217 PRINCESS ANNE ST
Mailing Address - Street 2:SUITE 202-1
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3353
Mailing Address - Country:US
Mailing Address - Phone:540-373-9574
Mailing Address - Fax:540-373-1444
Practice Address - Street 1:2217 PRINCESS ANNE ST
Practice Address - Street 2:SUITE 202-1
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3353
Practice Address - Country:US
Practice Address - Phone:540-373-9574
Practice Address - Fax:540-373-1444
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002280101YP2500X
VA0717000143106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA317334OtherBLUE CROSS BLUE SHIELD
VA208766OtherCOMPSYCH
VA292OtherMEDIFLEX