Provider Demographics
NPI:1831306976
Name:BASINSKI, KATHLEEN ANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANNE
Last Name:BASINSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 NEW MARKET RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22308-1436
Mailing Address - Country:US
Mailing Address - Phone:703-963-6710
Mailing Address - Fax:
Practice Address - Street 1:6020 RICHMOND HIGHWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-2196
Practice Address - Country:US
Practice Address - Phone:703-963-6710
Practice Address - Fax:703-780-3230
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040049161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical