Provider Demographics
NPI:1114088127
Name:ATKINSON, JEAN PAULA (LPC)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:PAULA
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6542 MORNING GLEN CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5027
Mailing Address - Country:US
Mailing Address - Phone:703-339-2462
Mailing Address - Fax:
Practice Address - Street 1:11 HOPE RD STE 213
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7287
Practice Address - Country:US
Practice Address - Phone:540-658-0888
Practice Address - Fax:540-658-0855
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004078101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional