Provider Demographics
NPI:1356955785
Name:RICHARDS, KATHERINE GRACE (LCSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GRACE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:LCSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 S WOODLEY ST APT E
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-4021
Mailing Address - Country:US
Mailing Address - Phone:301-801-6652
Mailing Address - Fax:
Practice Address - Street 1:6300 STEVENSON AVE STE B
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3554
Practice Address - Country:US
Practice Address - Phone:703-935-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD199781041C0700X
VA09040100051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical