Healthcare Provider Details

I. General information

NPI: 1154248136
Provider Name (Legal Business Name): INTRINSEQ COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 RIVERSIDE PKWY STE 107
FREDERICKSBURG VA
22406-1094
US

IV. Provider business mailing address

150 RIVERSIDE PKWY STE 107
FREDERICKSBURG VA
22406-1094
US

V. Phone/Fax

Practice location:
  • Phone: 530-945-8475
  • Fax:
Mailing address:
  • Phone: 530-945-8475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY ANDERSON
Title or Position: LPC-S, OWNER
Credential: LPC-S, RPT
Phone: 540-699-0606