Healthcare Provider Details

I. General information

NPI: 1699030908
Provider Name (Legal Business Name): KATHERINE VALLIERE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERINE SEKELY LPC

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 04/29/2020
Certification Date: 04/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7969 ASHTON AVE
MANASSAS VA
20109-2885
US

IV. Provider business mailing address

7969 ASHTON AVE
MANASSAS VA
20109-2885
US

V. Phone/Fax

Practice location:
  • Phone: 703-792-7800
  • Fax:
Mailing address:
  • Phone: 703-792-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: