Provider Demographics
NPI:1164160958
Name:CATALDI, JENNA (MA, ATR, LPC-R)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:CATALDI
Suffix:
Gender:F
Credentials:MA, ATR, LPC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 JOHN CARLYLE ST APT 546
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-6860
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10640 PAGE AVENUE
Practice Address - Street 2:SUITE 340
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4012
Practice Address - Country:US
Practice Address - Phone:703-705-2565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health