Provider Demographics
NPI:1811054364
Name:CORDINGLEY, ROBERTA (LPC NCC)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:CORDINGLEY
Suffix:
Gender:F
Credentials:LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 CHURCH ST NE STE 101
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4742
Mailing Address - Country:US
Mailing Address - Phone:703-242-2313
Mailing Address - Fax:703-242-6368
Practice Address - Street 1:415 CHURCH ST NE STE 101
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4742
Practice Address - Country:US
Practice Address - Phone:703-242-2313
Practice Address - Fax:703-242-6368
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001839101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health