Provider Demographics
NPI:1609203124
Name:NEHRT, GENEVIEVE KATHLEEN (PSYD, CSAC)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:KATHLEEN
Last Name:NEHRT
Suffix:
Gender:F
Credentials:PSYD, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 PLANK RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-7104
Mailing Address - Country:US
Mailing Address - Phone:540-735-7112
Mailing Address - Fax:703-349-3063
Practice Address - Street 1:3920 PLANK RD
Practice Address - Street 2:SUITE 120
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-7104
Practice Address - Country:US
Practice Address - Phone:540-735-7112
Practice Address - Fax:703-349-3063
Is Sole Proprietor?:No
Enumeration Date:2013-09-29
Last Update Date:2013-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0710102820101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0710102820OtherVIRGINIA STATE LICENSE CSAC