Provider Demographics
NPI:1881747947
Name:NORMANDY-DOLBERG, JOAN M (LPC, MS, MED)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:M
Last Name:NORMANDY-DOLBERG
Suffix:
Gender:F
Credentials:LPC, MS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15517 MARIGOLD FALLS LN
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-3020
Mailing Address - Country:US
Mailing Address - Phone:703-447-4007
Mailing Address - Fax:
Practice Address - Street 1:15517 MARIGOLD FALLS LN
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-3020
Practice Address - Country:US
Practice Address - Phone:703-447-4007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003357101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
020677079OtherTRICARE
0007515480OtherAETNA
G901-0001OtherCARE FIRST BCBS
VA386764OtherANTHEM BCBS
561026OtherNCPPO
539747000OtherMAGELLAN