Healthcare Provider Details

I. General information

NPI: 1093629941
Provider Name (Legal Business Name): KYLE DARMSTEAD M.S., M.ED., RIC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 HUNTER PL STE 101
WOODBRIDGE VA
22192-3938
US

IV. Provider business mailing address

2510 HUNTER PL STE 101
WOODBRIDGE VA
22192-3938
US

V. Phone/Fax

Practice location:
  • Phone: 571-678-5558
  • Fax: 540-755-0354
Mailing address:
  • Phone: 571-678-5558
  • Fax: 540-755-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704019588
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: