Provider Demographics
NPI:1982817821
Name:ZAGAR, KRISTIN (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:ZAGAR
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 1:9358 MAIN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-5499
Mailing Address - Country:US
Mailing Address - Phone:703-887-9707
Mailing Address - Fax:703-464-0452
Practice Address - Street 1:9358 MAIN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5499
Practice Address - Country:US
Practice Address - Phone:703-887-9707
Practice Address - Fax:703-464-0452
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040065291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical