Provider Demographics
NPI:1386086718
Name:LAMA, STEPHANIE (MA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:LAMA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WASHINGTON BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-5717
Mailing Address - Country:US
Mailing Address - Phone:703-228-1550
Mailing Address - Fax:703-228-1171
Practice Address - Street 1:2100 WASHINGTON BLVD FL 3
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204
Practice Address - Country:US
Practice Address - Phone:703-228-1550
Practice Address - Fax:703-228-1171
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0711000341101YA0400X
VA0701007209101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)