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General NPI Number Information
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NPI Number | 1306987045
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Entity Type | Individual
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Provider Name | STEPHEN JAMES LALLY PH.D., ABPP
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Gender | Male
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1655 FORT MYER DR SUITE 700
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City | ARLINGTON
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State | VA
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Zip | 22209-3113
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Country | US
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Telephone | 703-527-1111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2501
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City | ALEXANDRIA
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State | VA
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Zip | 22301-0501
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Country | US
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Telephone | 703-527-1111
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1532
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2529
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1540
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2182
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License Number State | VA
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