Provider Demographics
NPI:1003566225
Name:PERINI, KERSTIN (LPC)
Entity Type:Individual
Prefix:
First Name:KERSTIN
Middle Name:
Last Name:PERINI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 437
Mailing Address - Street 2:
Mailing Address - City:DUNN LORING
Mailing Address - State:VA
Mailing Address - Zip Code:22027-0437
Mailing Address - Country:US
Mailing Address - Phone:703-300-7576
Mailing Address - Fax:
Practice Address - Street 1:2025 MEADOW SPRINGS DR
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3770
Practice Address - Country:US
Practice Address - Phone:703-300-7576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005835101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701005835OtherLICENSE