Provider Demographics
NPI:1265796775
Name:KROLL, GLORIA JEANNE (LPC, CSAC)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:JEANNE
Last Name:KROLL
Suffix:
Gender:F
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 7TH ST S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1519
Mailing Address - Country:US
Mailing Address - Phone:703-920-4843
Mailing Address - Fax:
Practice Address - Street 1:407 N WASHINGTON ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3430
Practice Address - Country:US
Practice Address - Phone:703-407-9105
Practice Address - Fax:703-897-5882
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2013-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710102689101YA0400X
VA0701005265101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)