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CLINTON LEE BROGDON LPC
NPI 1457880684
Counselor - Professional in Fairfax, VA

Active since June 10, 2017
11204 WAPLES MILL RD, FAIRFAX, VA 22030(703) 218-8500(703) 359-0463 Get Directions Write a Review

NPPES record last updated: April 1, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 1, 2020, Jun 10, 2017 (2 updates tracked since 2017).

About Clinton Lee Brogdon Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLINTON LEE BROGDON LPC (NPI 1457880684) is an individual professional provider in Fairfax, Virginia, licensed in Virginia (0701007411) and active in the NPI registry since June 2017. He maintains a secondary practice location in Chantilly.

NPPES Registry Identity

NPI1457880684
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameCLINTON LEE BROGDONCredential: LPC
Location Address11204 WAPLES MILL RDFairfax, VA 22030-6036
Mailing AddressPo Box 230444Centreville, VA 20120-0444 · (571) 528-0805
Phone(703) 218-8500
Fax(703) 359-0463
Sole ProprietorYes
Enumeration DateJune 10, 2017
Last NPPES UpdateApril 1, 20202 updates tracked since enumeration
NPPES CertifiedApril 1, 2020
✔ NPI 1457880684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in VA · 0701007411
11204 WAPLES MILL RD, Fairfax, VA 22030
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Secondary Practice Location 1

Location 114143 Robert Paris CtChantilly, VA 20151-4201 · Phone (571) 528-0805

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RAVINDERPAL SINGH M.D,
Psychiatry & Neurology (Child & Adolescent Psychiatry)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8500
HITOMI MAKINO
Counselor (Mental Health)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8500
ELIZABETH ANNE BROCATO LCSW
Social Worker (Clinical)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8571
STEPHANIE RENEE MAYRANT MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8500
MICHELLE HENDRICKSON PH.D.
Psychologist (Clinical Child & Adolescent)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-2913
MS. SARAH JUNGSOO LIM LPC
Counselor (Professional)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8500
JANET GREIDER LPC
Counselor
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8500
DR. CATHERINE A RATHMAN PH.D.
Psychologist (Clinical Child & Adolescent)
11204 WAPLES MILL RD
FAIRFAX, VA 22030
Fairfax City (703) 218-8536

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clinton Brogdon's NPI number?

The NPI number for Clinton Brogdon is 1457880684. It was assigned to this individual provider in the NPPES registry on June 10, 2017.

Where is Clinton Brogdon located?

Clinton Brogdon practices at 11204 Waples Mill Rd, Fairfax, VA 22030. The listed phone number is (703) 218-8500.

What is Clinton Brogdon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Clinton Brogdon was last updated on April 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.