Provider Demographics
NPI:1821708934
Name:LANTZ, EUGENIA (MS, LPC-R)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:LANTZ
Suffix:
Gender:F
Credentials:MS, LPC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5813 IRONSTONE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-7722
Mailing Address - Country:US
Mailing Address - Phone:571-242-5146
Mailing Address - Fax:
Practice Address - Street 1:2008 BREMO RD STE 111
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2443
Practice Address - Country:US
Practice Address - Phone:804-404-6167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704015370101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health