Healthcare Provider Details

I. General information

NPI: 1871612358
Provider Name (Legal Business Name): PATRICIA LOUISE KIRTLEY LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3837 PEAKLAND PL #3
LYNCHBURG VA
24503-2045
US

IV. Provider business mailing address

3837 PEAKLAND PL #3
LYNCHBURG VA
24503-2045
US

V. Phone/Fax

Practice location:
  • Phone: 434-385-3428
  • Fax: 434-385-3428
Mailing address:
  • Phone: 434-385-3428
  • Fax: 434-385-3428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701001533
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717000718
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: