Provider Demographics
NPI:1598117400
Name:KLUBERTANZ, KALI C (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KALI
Middle Name:C
Last Name:KLUBERTANZ
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 1:19 S CAMERON ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4747
Mailing Address - Country:US
Mailing Address - Phone:540-550-8083
Mailing Address - Fax:
Practice Address - Street 1:19 S CAMERON ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4747
Practice Address - Country:US
Practice Address - Phone:540-550-8083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006569101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health