Individual
MRS. KELLY L CIPERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LISW
Contact information
Practice address
10432 BALLS FORD RD STE 300, MANASSAS, VA 20109
(571) 469-7106
Mailing address
10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517
(571) 469-7106
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904012107
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904012107
LICENCED CLINICAL SOCIAL WORKER
VA
01
—
I.2203500
LICENSED INDEPENDENT SOCIAL WORKER
OH
Enumeration date
07/20/2020
Last updated
03/22/2022
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