Provider Demographics
NPI:1598521577
Name:KRAFT, KATHERINE (MA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:KRAFT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9720 CAPITAL CT STE 303
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-2051
Mailing Address - Country:US
Mailing Address - Phone:833-382-5433
Mailing Address - Fax:703-881-0121
Practice Address - Street 1:9720 CAPITAL CT STE 303
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-2051
Practice Address - Country:US
Practice Address - Phone:833-382-5433
Practice Address - Fax:703-881-0121
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013319101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional