Provider Demographics
NPI:1457682270
Name:SONSTEGARD, KIRSTEN (LCSW)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:SONSTEGARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 GREYSTONE TER
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4444
Mailing Address - Country:US
Mailing Address - Phone:866-627-6726
Mailing Address - Fax:
Practice Address - Street 1:31 S BRADDOCK ST
Practice Address - Street 2:SUITE 208
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4144
Practice Address - Country:US
Practice Address - Phone:866-627-6726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-18
Last Update Date:2014-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA9040034231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical