Provider Demographics
NPI:1598815524
Name:BIRKLAND, KRISTEN LUNDBERG (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:LUNDBERG
Last Name:BIRKLAND
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19441 GOLF VISTA PLZ
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8269
Mailing Address - Country:US
Mailing Address - Phone:703-638-8082
Mailing Address - Fax:703-729-8836
Practice Address - Street 1:19441 GOLF VISTA PLZ
Practice Address - Street 2:SUITE 110
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8269
Practice Address - Country:US
Practice Address - Phone:703-638-8082
Practice Address - Fax:703-729-8836
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001117106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist