Healthcare Provider Details

I. General information

NPI: 1588282685
Provider Name (Legal Business Name): KEYSTONE THERAPY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5641 BURKE CENTRE PKWY STE 118
BURKE VA
22015-2261
US

IV. Provider business mailing address

5641 BURKE CENTRE PKWY STE 118
BURKE VA
22015-2261
US

V. Phone/Fax

Practice location:
  • Phone: 703-390-1182
  • Fax: 844-269-1569
Mailing address:
  • Phone: 703-390-1182
  • Fax: 844-269-1569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERLY ANN LANGLAIS RIPPY
Title or Position: LPC & OWNER
Credential: LPC
Phone: 703-390-1182