Healthcare Provider Details

I. General information

NPI: 1508470659
Provider Name (Legal Business Name): MISS KATHLEEN ERIN DOPPELHEUER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2020
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20145 ASHBROOK PL STE 180
ASHBURN VA
20147-3373
US

IV. Provider business mailing address

20145 ASHBROOK PL STE 180
ASHBURN VA
20147-3373
US

V. Phone/Fax

Practice location:
  • Phone: 703-534-5100
  • Fax:
Mailing address:
  • Phone: 703-534-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number704014759
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberPPS-0607675
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: