Healthcare Provider Details

I. General information

NPI: 1265401657
Provider Name (Legal Business Name): KAREN RENEE HOBBS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 GENESEE PL SUITE 109
WOODBRIDGE VA
22192-8302
US

IV. Provider business mailing address

4408 ECHO CT
WOODBRIDGE VA
22193-2713
US

V. Phone/Fax

Practice location:
  • Phone: 703-583-7504
  • Fax: 703-583-7507
Mailing address:
  • Phone: 703-772-2023
  • Fax: 706-670-0172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701003114
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: