Provider Demographics
NPI:1902028608
Name:KAUFMAN, MICHAEL A (LPC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 WELBORN DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-3424
Mailing Address - Country:US
Mailing Address - Phone:301-229-7678
Mailing Address - Fax:
Practice Address - Street 1:205 E HIGH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5116
Practice Address - Country:US
Practice Address - Phone:434-977-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001183101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health