Provider Demographics
NPI:1760674741
Name:BERJANSKY, LINDSEY KELLER (PSYD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:KELLER
Last Name:BERJANSKY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44095 PIPELINE PLZ STE 130
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7515
Mailing Address - Country:US
Mailing Address - Phone:703-721-7521
Mailing Address - Fax:
Practice Address - Street 1:44095 PIPELINE PLZ STE 130
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7515
Practice Address - Country:US
Practice Address - Phone:703-721-7521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003828103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1760674741Medicaid
VA14850C11Medicare PIN