SearchVirginia1041C0700X

Lisa Jackson-Wardlaw, LCSW

NPI 1427404599 · on the registry since 2016 · sole proprietor

Practice

Address
13503 Lee Jackson Memorial Hwy
Chantilly, VA 20151
Phone
(571) 730-7743

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Also registered as
1041C0700X
1041C0700X
Licence states on file
LA, OR, VA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-07-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia