# J L FRISTAD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487148490
- **Authorized official:** JANICE L FRISTAD LCSW (EXECUTIVE OFFICER)
- **Authorized official phone:** (703) 474-6202

## Contact information

- **Practice address:** 2 CARDINAL PARK DR SE STE 104A, LEESBURG, VA 20175-4448
- **Practice address phone:** (703) 980-9715
- **Mailing address:** 1206 MUSKET CT NE, LEESBURG, VA 20176-4805
- **Mailing address phone:** (703) 474-6202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 06/22/2018
- **Last updated:** 09/14/2022