Healthcare Provider Details

I. General information

NPI: 1285610030
Provider Name (Legal Business Name): JUDY A STONE LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 10/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10560 MAIN ST SUITE 410
FAIRFAX VA
22030-7182
US

IV. Provider business mailing address

10810 PAYNES CHURCH DR
FAIRFAX VA
22032-2916
US

V. Phone/Fax

Practice location:
  • Phone: 703-352-8534
  • Fax:
Mailing address:
  • Phone: 703-278-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701001414
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717000816
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: