person
Kelly Elaine Vandivert, LPC
Professional Counselor in Fredericksburg, Virginia
NPI 1578718987

Kelly Elaine Vandivert is a Professional Counselor based in Louisa, VA and is specialized in Professional. Kelly Elaine Vandivert practices in Fredericksburg, VA and has the professional credentials of LPC. The NPI Number for Kelly Elaine Vandivert is 1578718987 and holds a License No. 0701004449 (Virginia).

The current practice location address for Kelly Elaine Vandivert is 406 Chatham Sq Park, Fredericksburg, VA and can be reached out via phone at 703-819-7538 and via fax at 540-373-6266.

Location: 406 Chatham Sq Park, Fredericksburg, VA, 23093-6229
person
Provider Profile Details
NPI Number
1578718987
Provider Name
Kelly Elaine Vandivert
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
406 Chatham Sq Park, Fredericksburg, VA, 23093-6229
Phone Number
703-819-7538
Fax Number
540-373-6266
Provider Enumeration Date
11/26/2008
Last Update Date
07/20/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004945247 05 VA
C02810 01 VA MEDICARE
institution
Provider Business Practice Location Address Details
Address
406 Chatham Sq Park
City
State
Zip
22405-2585
Phone Number
703-819-7538
Fax Number
540-373-6266
person
Provider Business Mailing Address Details
Address
406 Chatham Sq Park
City
State
Zip
22405-2585
Phone Number
703-819-7538
Fax Number
540-373-6266
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
0701004449 (Virginia)
Definition
Definition to come...
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