Provider Demographics
NPI:1831680214
Name:LOUCKA, RADKA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:RADKA
Middle Name:
Last Name:LOUCKA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HOPE ROAD
Mailing Address - Street 2:SUITE 111, P.O. BOX 222
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554
Mailing Address - Country:US
Mailing Address - Phone:540-426-9700
Mailing Address - Fax:540-699-6938
Practice Address - Street 1:2124 JEFFERSON DAVIS HIGHWAY
Practice Address - Street 2:SUITE 202
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554
Practice Address - Country:US
Practice Address - Phone:540-426-9700
Practice Address - Fax:540-699-6938
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007592101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health