Healthcare Provider Details

I. General information

NPI: 1598107849
Provider Name (Legal Business Name): CAITLYN WEINHOLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5999 BURKE COMMONS RD STE 200
BURKE VA
22015-2880
US

IV. Provider business mailing address

5999 BURKE COMMONS RD STE 200
BURKE VA
22015-2880
US

V. Phone/Fax

Practice location:
  • Phone: 703-249-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPRC15416
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC10901
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701008397
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: