Healthcare Provider Details

I. General information

NPI: 1598688285
Provider Name (Legal Business Name): KRISTINE LAWRENCE M.S. ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S PITT ST
ALEXANDRIA VA
22314-3112
US

IV. Provider business mailing address

112 S PITT ST
ALEXANDRIA VA
22314-3112
US

V. Phone/Fax

Practice location:
  • Phone: 703-576-5491
  • Fax:
Mailing address:
  • Phone: 703-576-5491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704019325
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: