KATELYN E CLARK LPC
NPI 1194485912
Counselor - Professional in Bristow, VA
Active since December 20, 2021
About Katelyn E Clark Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATELYN E CLARK LPC (NPI 1194485912) is an individual professional provider in Bristow, Virginia, licensed in Virginia (0701011080) and active in the NPI registry since December 2021.
NPPES Registry Identity
NPI1194485912
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKATELYN E CLARKCredential: LPC
Location Address11835 HAZEL CIRCLE DRBristow, VA 20136-1223
Mailing Address11835 Hazel Circle DrBristow, VA 20136-2180 · (571) 416-0537
Phone(571) 416-0537
Sole ProprietorNo
Enumeration DateDecember 20, 2021
NPPES CertifiedDecember 20, 2021
✔ NPI 1194485912 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 · 0701011080
11835 HAZEL CIRCLE DR, Bristow, VA 20136
Other Providers at the Same Location NPPES 19
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Counselor (Professional)
11835 HAZEL CIRCLE DR
BRISTOW, VA 20136
BRISTOW, VA 20136
Counselor (Addiction (Substance Use Disorder))
11835 HAZEL CIRCLE DR
BRISTOW, VA 20136
BRISTOW, VA 20136
Community/Behavioral Health
11835 HAZEL CIRCLE DR
BRISTOW, VA 20136
BRISTOW, VA 20136
Clinic/Center (Community Health)
11835 HAZEL CIRCLE DR
BRISTOW, VA 20136
BRISTOW, VA 20136
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194485912, enumerated as an "individual" on December 20, 2021.
The provider is located at 11835 HAZEL CIRCLE DR BRISTOW, VA 20136 and the phone number is (571) 416-0537.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
