Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fountain of Life LLC

Organization Clinical Psychologist · NPI 1396286019

Fountain of Life LLC is a Clinical Psychologist in Falls Church, Virginia. Licensed in Virginia. Registered with an NPI since 2017.

Licensed in
VA
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

450 W Broad St Ste 211
Falls Church, VA 22046-3318
Phone: (571) 277-4919
Fax: (703) 241-1122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 0810002980 (VA)

Record details

NPI number1396286019
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Klewicki — Clinical Psychologist · (571) 277-4919
NPI enumeratedMarch 14, 2017
Last updated in NPPESMarch 14, 2017
Mailing address450 W Broad St Ste 211, Falls Church, VA 22046-3318

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