LIFELINE PSYCHOTHERAPY SERVICES


Address: 11350 Random Hills Rd Ste 800, Fairfax, VA 22030-6044
Phone: 7034096258

LIFELINE PSYCHOTHERAPY SERVICES (NPI# 1417469974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417469974
Entity Type Organization
Organization Name LIFELINE PSYCHOTHERAPY SERVICES
Practice Address 11350 Random Hills Rd Ste 800
Fairfax
VA 22030-6044
Mailing Address 12646 Heron Ridge Dr
Fairfax
VA 22030-6638
Practice Telephone 7034096258
Mailing Telephone 7034096258
Enumeration Date 2017-10-24
Last Update Date 2017-10-24
Authorized Official Name HOANG OANH RODGERS (OWNER)
Authorized Official Telephone 7034096258
Authorized Official Credential LMFT, LPC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
0710000893 VA Behavioral Health & Social Service Providers
N 101YP2500X Counselor
Specialization: Professional
0701002418 VA Behavioral Health & Social Service Providers
Y 106H00000X Marriage & Family Therapist 0717000800 VA Behavioral Health & Social Service Providers

Other Data Sources

Entity Type Entity Name Entity Address
Virginia Business Entities Lifeline Psychotherapy Services LLC 12646 Heron Ridge Drive, Fairfax, Virginia 22030

Office Location

Street Address 11350 RANDOM HILLS RD STE 800
City FAIRFAX
State VA
Zip Code 22030-6044

Providers in the same location

NPI Name Taxonomy Address Enumeration
1902412695 Emerging for Change Clinic/Center 11350 Random Hills Rd Ste 800, Fairfax, VA 22030-6044 2020-09-18
1568096493 Seniors Home Assistance, LLC Case Management 11350 Random Hills Rd Ste 800, Fairfax, VA 22030-6044 2020-03-01
1992355689 Mindful Psychological Health, Pllc Psychologist 11350 Random Hills Rd Ste 800, Fairfax, VA 22030-6044 2019-09-16
1639671472 Gifted Touch Homehealth Home Health 11350 Random Hills Rd Ste 800, Fairfax, VA 22030-6044 2018-03-07

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205449477 Perry Camp Jr. Psychologist 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 2020-08-28
1952940322 Brightview Fair Oaks, LLC Alzheimer Center (Dementia Center) 12725 Lee Highway, Fairfax, VA 22030 2020-01-02
1245871524 Tori Sprowl Behavioral Analyst 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 2019-10-08
1528612124 Paul Sarigianis Student in an Organized Health Care Education/Training Program 10379b Democracy Lane, Fairfax, VA 22030 2019-07-31
1497221303 Kahak, Inc. Day Training, Developmentally Disabled Services 10560 Main Street Suite Ps100, Fairfax, VA 22030 2018-10-17
1689177073 Shamoona Sharif Dentist 11050 Lee Hwy, Fairfax, VA 22030 2018-03-13
1205339538 Rachael Lee Greene Social Worker 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 2018-03-13
1558863027 Jacqueline Renee Bauer Skilled Nursing Facility 10701 Main Street, Fairfax, VA 22030 2018-03-01
1275033607 Philajo Global LLC Non-emergency Medical Transport (VAN) 4521 Billingham Street, Fairfax, VA 22030 2018-02-12
1376050401 Alexander Harrison Counselor 4400 University Drive, Ms 2a2, Fairfax, VA 22030 2018-01-10
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Taxonomy Information

Taxonomy Code 106H00000X
Grouping Behavioral Health & Social Service Providers
Classification Marriage & Family Therapist

Taxonomy Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1336755800 Samantha N Terriss Marriage & Family Therapist 80 Dominga Ave, Fairfax, CA 94930-1604 2020-09-21
1417431149 Jonathan Dixon Marriage & Family Therapist 9677 Main St # A-b, Fairfax, VA 22031-3763 2018-09-19
1730579673 Victoria Alexis Mckenna Marriage & Family Therapist 10570 Main St, Apt 511, Fairfax, VA 22030-7113 2015-01-30
1649606187 Jason Neal Linder Marriage & Family Therapist 189 Canyon Road, Fairfax, CA 94930 2013-09-16
1790031854 Maureen Smith Bethea Marriage & Family Therapist 10640 Page Ave Ste 210, Fairfax, VA 22030-4000 2012-07-26
1043549595 Gail Danchig Marriage & Family Therapist 110 Willow Ave, Fairfax, CA 94930-1220 2009-12-11
1407029291 Amy Ione Holle Marriage & Family Therapist 351 Olema Rd, Fairfax, CA 94930-1339 2008-04-11
1295948834 Alexander Binik Marriage & Family Therapist 7 Meadow Way, Fairfax, CA 94930-2151 2007-05-08
1811064090 Brent L Bowen Marriage & Family Therapist 10605 Judicial Dr, Building A-4, Fairfax, VA 22030-5167 2006-11-30
1265031728 Rachel Cheche Hoover Marriage & Family Therapist 10640 Page Ave Ste 210, Fairfax, VA 22030-4000 2020-10-25
Find all providers in FAIRFAX

Competitor

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City FAIRFAX
Zip Code 22030

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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