Provider Demographics
NPI:1285214916
Name:KIRVEN, NICOLE LASHAWN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:LASHAWN
Last Name:KIRVEN
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 1:121 FREESIA LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-2552
Mailing Address - Country:US
Mailing Address - Phone:540-840-6832
Mailing Address - Fax:
Practice Address - Street 1:121 FREESIA LN
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-2552
Practice Address - Country:US
Practice Address - Phone:540-840-6832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005760101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional