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General NPI Number Information
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NPI Number | 1093848590
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Entity Type | Individual
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Provider Name | LESLIE CATHERINE KILPATRICK MED., MSW
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 09/28/2018
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Provider Practice Location Address
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Address Line | 4121 KENTMERE SQ
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City | FAIRFAX
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State | VA
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Zip | 22030
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Country | US
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Telephone | 703-691-3578
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Fax |
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Provider Business Mailing Address
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Address Line | 4121 KENTMERE SQ
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City | FAIRFAX
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State | VA
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Zip | 22030-6062
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Country | US
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Telephone | 703-691-3578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904007679
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 22977
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50081101
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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