Provider Demographics
NPI:1356710800
Name:LEADMAN, MARNIE PARKER (LPC)
Entity type:Individual
Prefix:
First Name:MARNIE
Middle Name:PARKER
Last Name:LEADMAN
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 1:43588 EVERGOLD TER UNIT 403
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7811
Mailing Address - Country:US
Mailing Address - Phone:804-221-0395
Mailing Address - Fax:703-665-9853
Practice Address - Street 1:43588 EVERGOLD TER UNIT 403
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7811
Practice Address - Country:US
Practice Address - Phone:804-221-0395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006191101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional