Provider Demographics
NPI:1861673360
Name:LEA, ANTHONY MURDOCK (LPC, LMFT, LSATP)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:MURDOCK
Last Name:LEA
Suffix:
Gender:M
Credentials:LPC, LMFT, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9947 HULL STREET RD
Mailing Address - Street 2:PMB 151
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236-1412
Mailing Address - Country:US
Mailing Address - Phone:804-864-2660
Mailing Address - Fax:804-864-2660
Practice Address - Street 1:306 TURNER RD
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-6432
Practice Address - Country:US
Practice Address - Phone:804-864-2660
Practice Address - Fax:804-864-2661
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000042101YA0400X
VA0701002283101YM0800X
VA0717000407106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist