Organization
LAKESIDE PSYCHOLOGICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLLE MICHALSKI (OWNER)
(509) 850-1014
Entity
Organization
Contact information
Practice address
3403 STONEYBRAE DR, FALLS CHURCH, VA 22044-1225
(509) 850-1014
Mailing address
3403 STONEYBRAE DR, FALLS CHURCH, VA 22044-1225
(509) 850-1014
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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