Provider Demographics
NPI:1811582752
Name:TASCHMAN, KATRINA (LMFT)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:TASCHMAN
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 1:9048 CENTERWAY RD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-1811
Mailing Address - Country:US
Mailing Address - Phone:240-338-2058
Mailing Address - Fax:
Practice Address - Street 1:3923 OLD LEE HWY STE 63D
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2428
Practice Address - Country:US
Practice Address - Phone:240-338-2058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM822106H00000X
VA0717001796106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist