Healthcare Provider Details

I. General information

NPI: 1598067456
Provider Name (Legal Business Name): KIMBERLY CULPEPPER LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 11/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20905 PROFESSIONAL PLZ SUITE 220
ASHBURN VA
20147-7783
US

IV. Provider business mailing address

20905 PROFESSIONAL PLZ SUITE 220
ASHBURN VA
20147-7783
US

V. Phone/Fax

Practice location:
  • Phone: 703-858-9841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701004946
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: