Lisa Xantus, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701009998 Issued in VA

Practice address

3102 Golansky Blvd Ste 202
Woodbridge, VA 22192-4244

Phone

(703) 596-3978

NPI assigned

May 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• LBX Therapy Center LLC

  • Professional Counselor
  • Woodbridge, VA
  • NPI 1043811334
  NPD Authorized official
• Empowerment Therapy Center, Etc

  • Mental Health Counselor
  • Manassas, VA
  • NPI 1568976785
  NPD (past)

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1972127694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 GOLANSKY BLVD STE 202",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 GOLANSKY BLVD STE 202",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924244",
            "telephone_number": "703-596-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XANTUS",
        "first_name": "LISA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701009998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Vladimirovna Wymore
• Todd E Wynkoop, DDS
• Alan Howard Wynn, M.D.
• Andrew Ross Wynn, LCSW
• Erica Larae Wynn, M.D.
• Duo Xu, APRN
• Y Mentorship Services LLC
• Charles Yaafi
• Ellen Marie Yach, LPTA
• Anastasiya Puritz Yakovenko, MD

• Professional Counselor in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.