Provider Demographics
NPI:1811519986
Name:SIEVERS, KENDRA A
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:A
Last Name:SIEVERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 BRIXHAM CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015
Mailing Address - Country:US
Mailing Address - Phone:703-615-1870
Mailing Address - Fax:
Practice Address - Street 1:SEVEN CORNERS PSYCHOTHERAPY
Practice Address - Street 2:6059 B ARLINGTON BLVD
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044
Practice Address - Country:US
Practice Address - Phone:703-615-1870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2021-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040131041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904013104OtherNASW
DCLC200001423OtherNASW