Provider Demographics
NPI:1184446809
Name:KIPERS, NATHANIEL (LMSW, LSW)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:
Last Name:KIPERS
Suffix:
Gender:M
Credentials:LMSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6841 MELROSE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101
Mailing Address - Country:US
Mailing Address - Phone:703-955-2876
Mailing Address - Fax:
Practice Address - Street 1:2501 NORTH GLEBE ROAD
Practice Address - Street 2:SUITE 303
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207
Practice Address - Country:US
Practice Address - Phone:703-841-1290
Practice Address - Fax:703-841-1315
Is Sole Proprietor?:No
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141699104100000X
VA0903004267104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker