Provider Demographics
NPI:1710908959
Name:ROSENTHAL, KRISTIN B (LPC)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:B
Last Name:ROSENTHAL
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 1:1707 BELLE VIEW BLVD APT C1
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-6727
Mailing Address - Country:US
Mailing Address - Phone:703-768-6240
Mailing Address - Fax:703-768-6264
Practice Address - Street 1:1707 BELLE VIEW BLVD APT C1
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22307-6727
Practice Address - Country:US
Practice Address - Phone:703-768-6240
Practice Address - Fax:703-768-6264
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001812101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health