Doctor Name: | MISS KIRSTEN MARIE LUNDEBERG |
NPI Number: | 1710198254 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, LMFT |
License Number: | 0701003520 |
Business Practice Address: | 3923 Old Lee Hwy Suite 63d Fairfax, VA - 220302428 |
Business Phone Number: | 7035991478 |
Business Fax Number: | |
Mailing Address: | 706 N Armistead St, ALEXANDRIA |
State: | VA |
Postal Code: | 223122937 |
Phone Number: | 7033335328 |
Fax Number: | |
NPI Enumeration Date: | 05/25/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 0701003520 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |