Healthcare Provider Details

I. General information

NPI: 1720153190
Provider Name (Legal Business Name): KATHLEEN M VERANO LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5516 FALMOUTH ST. STE. 305
RICHMOND VA
23230
US

IV. Provider business mailing address

1000 JEFFERSON ST. STE. 2C
LYNCHBURG VA
24504
US

V. Phone/Fax

Practice location:
  • Phone: 804-554-0356
  • Fax: 804-966-5639
Mailing address:
  • Phone: 617-379-0496
  • Fax: 617-807-0958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002088
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717000860
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: