Healthcare Provider Details

I. General information

NPI: 1508664350
Provider Name (Legal Business Name): LISA ATKINS LPC-R
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21351 GENTRY DR STE 200
STERLING VA
20166-8512
US

IV. Provider business mailing address

21351 GENTRY DR STE 200
STERLING VA
20166-8512
US

V. Phone/Fax

Practice location:
  • Phone: 703-493-0891
  • Fax:
Mailing address:
  • Phone: 703-493-0891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704016585
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: