Provider Demographics
NPI:1184273088
Name:SAUNDERS, ALICIA DOMINQUE (LPC)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:DOMINQUE
Last Name:SAUNDERS
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 1:620 COURT ST
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24504-1312
Mailing Address - Country:US
Mailing Address - Phone:434-455-3043
Mailing Address - Fax:434-948-4855
Practice Address - Street 1:25 LEWIS WAY
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-3607
Practice Address - Country:US
Practice Address - Phone:434-455-3043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008576101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional