Provider Demographics
NPI:1124716360
Name:TOMALA, LISA M (LPC, MS)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:TOMALA
Suffix:
Gender:F
Credentials:LPC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:662 JOHN TYLER CIR APT 301
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-2579
Mailing Address - Country:US
Mailing Address - Phone:540-525-8216
Mailing Address - Fax:
Practice Address - Street 1:20755 WILLIAMSPORT PL STE 390
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6523
Practice Address - Country:US
Practice Address - Phone:571-832-5077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013799101YP2500X
VA0704008184101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health