Provider Demographics
NPI:1699776021
Name:FIELD, LYNN FERTELL (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:FERTELL
Last Name:FIELD
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10721 MAIN ST
Mailing Address - Street 2:SUITE 2350
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6914
Mailing Address - Country:US
Mailing Address - Phone:703-591-5912
Mailing Address - Fax:703-591-7210
Practice Address - Street 1:10721 MAIN ST
Practice Address - Street 2:SUITE 2350
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6914
Practice Address - Country:US
Practice Address - Phone:703-591-5912
Practice Address - Fax:703-591-7210
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002865101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional