MEDICARE: JEAN PAULA ATKINSON 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	0701004078	VA

General Provider Information

NPI Number	:	1114088127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN PAULA ATKINSON LPC

Provider Business Mailing Address
First Line	:	6542 MORNING GLEN CT
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22315-5027
Country	:	US
Telephone Number	:	703-339-2462
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 HOPE RD STE 213
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22554-7287
Country	:	US
Telephone Number	:	540-658-0888
Fax Number	:	540-658-0855

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	07/08/2007

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