Healthcare Provider Details

I. General information

NPI: 1518762905
Provider Name (Legal Business Name): KATHERINE HURD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1495 CHAIN BRIDGE RD
MC LEAN VA
22101-5727
US

IV. Provider business mailing address

2454 N JEFFERSON ST
ARLINGTON VA
22207-1414
US

V. Phone/Fax

Practice location:
  • Phone: 703-598-5559
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017942
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: