Provider Demographics
NPI:1013319458
Name:CUDA, LINA (LPC)
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:CUDA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LINA
Other - Middle Name:
Other - Last Name:VAICEKAUSKAITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8422 ELECTRIC AVE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-5109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8422 ELECTRIC AVE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-5109
Practice Address - Country:US
Practice Address - Phone:703-849-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005715101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1447279658Medicaid