Individual
KELLY AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
9105A OWENS DR STE 102, MANASSAS PARK, VA 20111-4852
(571) 331-9704
(855) 755-7769
Mailing address
7118 KNOTTY OAK LN, MANASSAS, VA 20112-3235
(571) 445-0265
(855) 755-7769
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717001391
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0717001391
STATE LICENSE
VA
Enumeration date
06/20/2016
Last updated
02/02/2026
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