Lisa M Kellogg, LPC, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0717001833 Issued in VA

Practice address

11350 Random Hills Rd Ste 310
Fairfax, VA 22030-6044

Phone

(703) 865-4900

Fax

(703) 865-4922

NPI assigned

Sep 2, 2011

Last updated

Mar 17, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Other names 1

• Dr. Lisa M Duncan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 31, 2025 through Mar 31, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bridges Therapy and Wellness Center, LLC

  • Clinical Psychologist
  • Fairfax, VA
  • NPI 1669714903
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1396026431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 RANDOM HILLS RD STE 310",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306044",
            "telephone_number": "703-865-4900",
            "fax_number": "703-865-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 RANDOM HILLS RD STE 310",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306044",
            "telephone_number": "703-865-4900",
            "fax_number": "703-865-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "LPC, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-02",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2013014601",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0701010706",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "P2011105",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "LCM991",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DUNCAN",
            "middle_name": "M",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenna Kelley, MS, LPC, ATR
• Kayla M Kelley, M.S., SLP-CCC
• Shannon Marie Kelley, M.ED, BCBA
• Daniel P. Kelliher, D.D.S
• Gary M. Kellman, MD
• Andrea Isabel Kelly, BCBA
• Chelsea Kelly, ATC
• Joseph J Kelly, DC
• Kathleen A Kelly, MD
• Kevin James Kelly, PSY.D.

• Marriage & Family Therapist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Marriage & Family Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.