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NPI Code Detail

MEDICARE: MS. KATHLEEN CHRANLEY FORT LCSW

MEDICARE:  MS. KATHLEEN CHRANLEY FORT  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker149.012283IL
21041C0700XClinical Social Worker0904003888VA
31041C0700XClinical Social WorkerLC303410DC
41041C0700XClinical Social Worker10479MD

General Provider Information

NPI Number : 1306966296
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN CHRANLEY FORT LCSW
Provider Business Mailing Address
First Line : 3018 JAVIER RD
Second Line :
City : FAIRFAX
State : VA
Zip : 22031-4609
Country : US
Telephone Number : 703-204-9100
Fax Number : 703-204-9590
Provider Business Practice Location Address
First Line : 3018 JAVIER RD
Second Line :
City : FAIRFAX
State : VA
Zip : 22031-4609
Country : US
Telephone Number : 703-204-9100
Fax Number : 703-204-9590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 09/24/2013

Similar Medicare Providers

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Practice Location Address:
3018 JAVIER RD
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1447356407 — MS. SARAH DOROTHY INCE LCSW
Practice Location Address:
3018 JAVIER RD
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22031-4609
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1063541977 — SUSAN E. JACOBSON NP
Practice Location Address:
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1588783278 — MRS. TREONA D BATEMAN LCSW
Practice Location Address:
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Practice Fax: 703-204-9590

Directions to “ MS. KATHLEEN CHRANLEY FORT LCSW” Practice Location

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