Active NPI
Angelique Lawrence, LCMFT, CASAC
- Marriage & Family Therapist
- Manassas, VA
National Provider Identifier
1760721252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 0717001324
- Practice address
- 9819 Sudley Manor Dr
Manassas, VA 20109-6230 - Phone
- (917) 680-2145
- NPI assigned
- Feb 5, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 23079 | NY | |
| Psychologist | 103T00000X | |||
| Marriage & Family Therapist | 106H00000X | 000059 | NY | |
| Marriage & Family Therapist | 106H00000X | 0717001324 | VA | Primary |
Addresses
Primary practice location
9819 Sudley Manor Dr
Manassas, VA 20109-6230
Mailing address
9819 Sudley Manor Dr
Manassas, VA 20109-6230
Phone (917) 680-2145
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23079 | NY | MD | Addiction (Substance Use Disorder) Counselor |
| 0717001324 | VA | MD | Marriage & Family Therapist |
| 000059 | NY | MD | Community Health Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A. Lawrence Christian Counseling LLC | Counselor | Current | Accepting new patients |
Locations
9890 Liberia Ave
Manassas, VA 20110
Phone (401) 533-3966
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598054400000",
"number": "1760721252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9819 SUDLEY MANOR DR",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201096230",
"telephone_number": "917-680-2145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9819 SUDLEY MANOR DR",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201096230",
"telephone_number": "917-680-2145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "ANGELIQUE",
"credential": "LCMFT, CASAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-05",
"last_updated": "2020-08-22",
"certification_date": "2020-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "23079",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NY",
"license": "000059",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "VA",
"license": "0717001324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.