Healthcare Provider Details

I. General information

NPI: 1124716360
Provider Name (Legal Business Name): LISA M TOMALA LPC, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 N GLEBE RD FL 5
ARLINGTON VA
22203-1853
US

IV. Provider business mailing address

23 E BEVERLEY ST
STAUNTON VA
24401-4322
US

V. Phone/Fax

Practice location:
  • Phone: 323-676-7425
  • Fax:
Mailing address:
  • Phone: 540-525-8216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704008184
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701013799
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: