Healthcare Provider Details

I. General information

NPI: 1619862984
Provider Name (Legal Business Name): ALEXANDRA LOBBAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 MARK CENTER DR
ALEXANDRIA VA
22311-1882
US

IV. Provider business mailing address

4850 MARK CENTER DR
ALEXANDRIA VA
22311-1882
US

V. Phone/Fax

Practice location:
  • Phone: 703-746-3401
  • Fax:
Mailing address:
  • Phone: 703-746-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701014859
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701014859
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: