Provider Demographics
NPI:1700017290
Name:KATHLEEN DRING, PLLC
Entity Type:Organization
Organization Name:KATHLEEN DRING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRING
Authorized Official - Suffix:
Authorized Official - Credentials:JD, PSYD
Authorized Official - Phone:757-318-7668
Mailing Address - Street 1:1020 INDEPENDENCE BLVD
Mailing Address - Street 2:STE. 214
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-5500
Mailing Address - Country:US
Mailing Address - Phone:757-318-7668
Mailing Address - Fax:757-318-7559
Practice Address - Street 1:1020 INDEPENDENCE BLVD
Practice Address - Street 2:STE. 214
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-5500
Practice Address - Country:US
Practice Address - Phone:757-318-7668
Practice Address - Fax:757-318-7559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2009-183023-R103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7709340Medicaid