Provider Demographics
NPI:1871671255
Name:FLOWERS, NINA KATHLEEN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:NINA
Middle Name:KATHLEEN
Last Name:FLOWERS
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 1:19415 DEERFIELD AVE STE 103B
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8470
Mailing Address - Country:US
Mailing Address - Phone:703-858-5507
Mailing Address - Fax:877-844-2901
Practice Address - Street 1:19415 DEERFIELD AVE STE 103B
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8470
Practice Address - Country:US
Practice Address - Phone:703-858-5507
Practice Address - Fax:877-844-2901
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003831101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA35-020747954F-001OtherTAX ACCOUNT NUMBER