Individual
MS. MAUREEN KIRBY LEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
230 SOUTH CRATER RD, PETERSBURG, VA 23803-4424
(804) 733-2180
(804) 733-8502
Mailing address
4540 CENTRALIA RD, CHESTER, VA 23831-1121
(804) 536-3884
(804) 733-8502
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701002686
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089394
SENTARA
VA
01
—
262826
ANTHEM BLUE CROSS BLUE SH
VA
01
—
3033951
AETNA
VA
Enumeration date
11/17/2006
Last updated
07/08/2007
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