MEDICARE: JOHN PAUL LENNON MA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701004907	VA

General Provider Information

NPI Number	:	1083962690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN PAUL LENNON MA, LPC

Provider Business Mailing Address
First Line	:	2100 WASHINGTON BLVD
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-5703
Country	:	US
Telephone Number	:	703-228-1523
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 WASHINGTON BLVD FL 3
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-5717
Country	:	US
Telephone Number	:	703-228-1523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2012
Last Update Date	:	08/29/2012

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