Provider Demographics
NPI:1790126951
Name:GREENLEAF, KATHERINE E (MA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:GREENLEAF
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 1:21641 RIDGETOP CIR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6597
Mailing Address - Country:US
Mailing Address - Phone:571-258-3026
Mailing Address - Fax:
Practice Address - Street 1:21641 RIDGETOP CIR
Practice Address - Street 2:SUITE 105
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6597
Practice Address - Country:US
Practice Address - Phone:571-258-3026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health