Healthcare Provider Details

I. General information

NPI: 1174454094
Provider Name (Legal Business Name): KERRY ELIZABETH BYRNE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8003 FRANKLIN FARMS DR STE 101131
RICHMOND VA
23229-5107
US

IV. Provider business mailing address

1559 HERITAGE HILL DR
RICHMOND VA
23238-4322
US

V. Phone/Fax

Practice location:
  • Phone: 804-716-0428
  • Fax:
Mailing address:
  • Phone: 804-716-0428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0904019702
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: