Provider Demographics
NPI:1376694463
Name:KIELKOPF, ANNETTE B (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:B
Last Name:KIELKOPF
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 CHAIN BRIDGE ROAD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4511
Mailing Address - Country:US
Mailing Address - Phone:703-288-9022
Mailing Address - Fax:
Practice Address - Street 1:1485 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4501
Practice Address - Country:US
Practice Address - Phone:703-288-9022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004004101YM0800X
VA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health