Provider Demographics
NPI:1275423808
Name:ENGLISH, KIMBERLY THIERRY (MED MAC ( SOON TO O)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:THIERRY
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:MED MAC ( SOON TO O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7408 RECARD LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-1846
Mailing Address - Country:US
Mailing Address - Phone:202-369-4326
Mailing Address - Fax:202-369-4326
Practice Address - Street 1:7008 LITTLE RIVER TPKE
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-5955
Practice Address - Country:US
Practice Address - Phone:703-740-3700
Practice Address - Fax:703-995-4548
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA510604101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor