Provider Demographics
NPI:1548500028
Name:KESSLER, LENA
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:KESSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4164 VIRGINIA BEACH BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1762
Mailing Address - Country:US
Mailing Address - Phone:757-622-1060
Mailing Address - Fax:757-622-1601
Practice Address - Street 1:4164 VIRGINIA BEACH BLVD STE 204
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1762
Practice Address - Country:US
Practice Address - Phone:917-346-8373
Practice Address - Fax:757-622-1601
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004616103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical