Healthcare Provider Details

I. General information

NPI: 1003144932
Provider Name (Legal Business Name): KRISTIN ELIZABETH SCHOLL L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2009
Last Update Date: 03/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7344 ELDORADO CT
MC LEAN VA
22102-2908
US

IV. Provider business mailing address

WTB WALTER REED NATIONAL MILITARY CTR 8901 ROCKVILLE PIKE
BETHESDA MD
20889-5600
US

V. Phone/Fax

Practice location:
  • Phone: 703-888-6965
  • Fax:
Mailing address:
  • Phone: 301-400-0415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904007134
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: