Provider Demographics
NPI:1962109272
Name:DICKINSON, LAUREN VICTORIA (LCSW, MSW)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:VICTORIA
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:VICTORIA
Other - Last Name:GRINDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, MSW
Mailing Address - Street 1:10461 WHITE GRANITE DRIVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124
Mailing Address - Country:US
Mailing Address - Phone:703-359-5160
Mailing Address - Fax:703-383-9574
Practice Address - Street 1:49480 YUKON DRIVE
Practice Address - Street 2:SUITE 206
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147
Practice Address - Country:US
Practice Address - Phone:703-723-3201
Practice Address - Fax:703-729-2736
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040138201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical