Healthcare Provider Details

I. General information

NPI: 1619765351
Provider Name (Legal Business Name): VICTORIA ELAINE RINALD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23164 DRAGOON RD
LIGNUM VA
22726-2036
US

IV. Provider business mailing address

2202 HAMWAY DR
FREDERICKSBURG VA
22407-1377
US

V. Phone/Fax

Practice location:
  • Phone: 540-399-5080
  • Fax:
Mailing address:
  • Phone: 434-218-8224
  • Fax: 434-218-8224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904016475
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: