Provider Demographics
NPI:1841301512
Name:DILLON, NINA ELIZABETH (LPC)
Entity type:Individual
Prefix:MS
First Name:NINA
Middle Name:ELIZABETH
Last Name:DILLON
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 1:4421 GORMAN DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-1905
Mailing Address - Country:US
Mailing Address - Phone:434-509-3446
Mailing Address - Fax:
Practice Address - Street 1:150 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-2010
Practice Address - Country:US
Practice Address - Phone:434-384-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003397101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAO80139OtherOPTIMA
VA171785OtherANTHEM