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General NPI Number Information
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NPI Number | 1194421826
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Entity Type | Individual
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Provider Name | LISA TON LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 3613 CHAIN BRIDGE RD
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City | FAIRFAX
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State | VA
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Zip | 22030-3238
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Country | US
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Telephone | 571-478-8614
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Fax |
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Provider Business Mailing Address
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Address Line | 2523 N LEXINGTON ST
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City | ARLINGTON
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State | VA
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Zip | 22207-1442
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Country | US
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Telephone | 571-478-8614
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904009754
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License Number State | VA
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