Provider Demographics
NPI:1184201030
Name:EASTERLING, KESHIA M (PHD, LPC, CEAP)
Entity Type:Individual
Prefix:DR
First Name:KESHIA
Middle Name:M
Last Name:EASTERLING
Suffix:
Gender:F
Credentials:PHD, LPC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20755 WILLIAMSPORT PL STE 390
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6523
Mailing Address - Country:US
Mailing Address - Phone:571-832-5077
Mailing Address - Fax:571-832-5078
Practice Address - Street 1:20755 WILLIAMSPORT PL STE 390
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6523
Practice Address - Country:US
Practice Address - Phone:571-832-5077
Practice Address - Fax:571-832-5078
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-26
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46.002690101YP2500X
NVCP5089-R101YP2500X
VA0701010318101YP2500X
FLTPMC1052101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health