Provider Demographics
NPI:1992217921
Name:GOETTINGER, VIVA KARIN (LPC)
Entity Type:Individual
Prefix:
First Name:VIVA
Middle Name:KARIN
Last Name:GOETTINGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 WEAVER TER NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2662
Mailing Address - Country:US
Mailing Address - Phone:202-222-5139
Mailing Address - Fax:
Practice Address - Street 1:5009 WEAVER TER NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2662
Practice Address - Country:US
Practice Address - Phone:202-222-5139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14639101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional