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Individual

KIERSTEN FARRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, LSATP

Contact information

Practice address
13410 TREY LN, CLIFTON, VA 20124-0923
(703) 217-8134
Mailing address
13410 TREY LN, CLIFTON, VA 20124-0923
(703) 217-8134

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0718000613
VA
101YM0800X
Mental Health Counselor
Primary
0701012520
VA

Other

Enumeration date
12/12/2022
Last updated
09/23/2023
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