Individual
KATHERINE MADSEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
19441 GOLF VISTA PLZ, SUITE 110, LEESBURG, VA 20176-8269
(703) 554-3260
(703) 729-8836
Mailing address
19441 GOLF VISTA PLZ, SUITE 110, LEESBURG, VA 20176-8269
(703) 554-3260
(703) 729-8836
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004211
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701004211
LPC LICENSE NUMBER
VA
01
—
11758310
CAQH ID
VA
Enumeration date
06/29/2007
Last updated
10/16/2009
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