Healthcare Provider Details

I. General information

NPI: 1871355966
Provider Name (Legal Business Name): CATHERINE JULIA LEHANKA RIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20116 ASHBROOK PL UNIT 110-120
ASHBURN VA
20147-5086
US

IV. Provider business mailing address

20116 ASHBROOK PL UNIT 110-120
ASHBURN VA
20147-5086
US

V. Phone/Fax

Practice location:
  • Phone: 703-436-1219
  • Fax:
Mailing address:
  • Phone: 703-436-1219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704019176
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: