Healthcare Provider Details

I. General information

NPI: 1356276489
Provider Name (Legal Business Name): MARGARET BOWES KENERLY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET CLAIRE BOWES

II. Dates (important events)

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

III. Provider practice location address

923 MAPLE GROVE DR STE 105
FREDERICKSBURG VA
22407-6937
US

IV. Provider business mailing address

11612 NEW BOND ST
FREDERICKSBURG VA
22408-1864
US

V. Phone/Fax

Practice location:
  • Phone: 540-842-2961
  • Fax:
Mailing address:
  • Phone: 540-842-2961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0904019558
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: