Provider Demographics
NPI:1508664350
Name:ATKINS, LISA (LPC-R)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ATKINS
Suffix:
Gender:
Credentials:LPC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17758 FORT STAR LN
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-7202
Mailing Address - Country:US
Mailing Address - Phone:571-246-1310
Mailing Address - Fax:
Practice Address - Street 1:21351 GENTRY DR STE 200
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-8512
Practice Address - Country:US
Practice Address - Phone:703-493-0891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704016585101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health