Basic Information
| Provider Information | |||||||||
| NPI: | 1114088127 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ATKINSON | ||||||||
| FirstName: | JEAN | ||||||||
| MiddleName: | PAULA | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6542 MORNING GLEN CT | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 223155027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7033392462 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11 HOPE RD STE 213 | ||||||||
| Address2: | |||||||||
| City: | STAFFORD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225547287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406580888 | ||||||||
| FaxNumber: | 5406580855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 0701004078 | VA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.