Individual
MS. KIM FELITA BURSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
720 N SAINT ASAPH ST, ALEXANDRIA, VA 22314-1912
(703) 838-4455
(703) 838-5070
Mailing address
16410 ELLIPSE TER, BOWIE, MD 20716-3262
(301) 809-6009
(301) 809-2178
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701002577
VA
101YP2500X
Professional Counselor
LC0137
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105
CAREFIRST BCBS
VA
01
—
188620
ANTHEM
VA
01
—
299085
AMERIGROUP VIRGINIA, INC.
VA
01
—
5460011003002
TRICARE
VA
Enumeration date
12/22/2006
Last updated
07/09/2007
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