Lakeside Psychological LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LAKESIDE PSYCHOLOGICAL LLC

Practice address

3403 Stoneybrae Dr
Falls Church, VA 22044-1225

Phone

(509) 850-1014

NPI assigned

Jun 7, 2023

Organization subpart

No

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

Authorized official

Name

Nicholle MichalskiNPI 1073272274

Title

Owner

Phone

(509) 850-1014

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholle Riane Johnston Michalski, PH.D.

  • Clinical Psychologist
  • Fort Belvoir, VA
  • NPI 1073272274
  NPD Authorized official

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1669166146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 STONEYBRAE DR",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220441225",
            "telephone_number": "509-850-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3403 STONEYBRAE DR",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220441225",
            "telephone_number": "509-850-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE PSYCHOLOGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "MICHALSKI",
        "authorized_official_first_name": "NICHOLLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-850-1014"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sylvia Lagarda, CCC-SLP
• Juan Carlos Lagares, LPC
• Pamela Macasaet Lagera, NP
• Margot Laimbeer
• Faminda T Lake, FAMINDA
• Ruhi H Lakhani, DNP, FNP
• Samir Lalani, D.P.M.
• Bai Lam
• Brian Pakyan Lam, PA-C
• Kevin Lam, MD

• Community/Behavioral Health Agency in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.