Healthcare Provider Details

I. General information

NPI: 1366474074
Provider Name (Legal Business Name): KIRSTEN LYNNE WINTERS LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PENNSYLVANIA AVE SE SUITE 201
WASHINGTON DC
20003-2167
US

IV. Provider business mailing address

801 PENNSYLVANIA AVE SE SUITE 201
WASHINGTON DC
20003-2167
US

V. Phone/Fax

Practice location:
  • Phone: 202-546-1512
  • Fax: 202-544-7282
Mailing address:
  • Phone: 202-546-1512
  • Fax: 202-544-7282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50078007
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: