Provider Demographics
NPI:1245966837
Name:PADALINO, KATHLEEN (LPC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:PADALINO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KATIE-ANNE
Other - Middle Name:
Other - Last Name:PADALINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:243 RIDGE MCINTIRE RD # 1029
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5043
Mailing Address - Country:US
Mailing Address - Phone:615-415-9452
Mailing Address - Fax:
Practice Address - Street 1:417 9TH ST NW
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4440
Practice Address - Country:US
Practice Address - Phone:615-415-9452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health