Provider Demographics
NPI:1053486373
Name:CATHOLIC CHARATIES DIOCESE OF ARLINGTON
Entity Type:Organization
Organization Name:CATHOLIC CHARATIES DIOCESE OF ARLINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTERAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-841-3835
Mailing Address - Street 1:305 HANSON AVE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401
Mailing Address - Country:US
Mailing Address - Phone:540-371-1124
Mailing Address - Fax:540-371-9038
Practice Address - Street 1:305 HANSON AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401
Practice Address - Country:US
Practice Address - Phone:540-371-1124
Practice Address - Fax:540-371-9038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NPI 1598723159OtherROSEMARIE GORTLER LPC
NPI 1639137243OtherCAROLYNNE B CROLL LCSW