Mayberry, Lorrie A
Mayberry, Lorrie A is an individual health care provider with primary practice located at 12721 Darby Brook Ct Suite 102, Woodbridge VA 22192-2408. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Mayberry, Lorrie A can be contacted via phone (703) 497-1771.Contact Information
Primary practice address
12721 Darby Brook Ct Suite 102
Woodbridge VA 22192-2408
Phone: (703) 497-1771
Fax: (703) 497-1225
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 0718000123 | Virginia |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 0701003902 | Virginia |
Profile Details
| NPI number | 1215979083 |
|---|---|
| LBN Legal business name | Mayberry, Lorrie A |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215979083 | NPPES |
| Virgin Islands | Other | 188901 | ANTHEM |
| Virgin Islands | Other | 088656M | ANTHEM |
| Virgin Islands | Other | 2140350 | ANTHEM |
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