Healthcare Provider Details

I. General information

NPI: 1982785705
Provider Name (Legal Business Name): KATHLEEN DRING PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 GLOUCESTER RD
CHARLOTTESVILLE VA
22901-1016
US

IV. Provider business mailing address

306 GLOUCESTER RD
CHARLOTTESVILLE VA
22901-1016
US

V. Phone/Fax

Practice location:
  • Phone: 757-749-7912
  • Fax:
Mailing address:
  • Phone: 757-749-7912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0810002565
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number0810002565
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number0810002565
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810002565
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: