Provider Demographics
NPI:1922132604
Name:WOODWARD, KIRSTEN RASMUSSEN (LCSW)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:RASMUSSEN
Last Name:WOODWARD
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 1:5703 ASHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-4104
Mailing Address - Country:US
Mailing Address - Phone:703-921-0883
Mailing Address - Fax:
Practice Address - Street 1:2713 MITSCHER ROAD SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20373
Practice Address - Country:US
Practice Address - Phone:202-433-4161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3032711041C0700X
VA09040034511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical