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General NPI Number Information
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NPI Number | 1710198254
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Entity Type | Individual
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Provider Name | KIRSTEN MARIE LUNDEBERG LPC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3923 OLD LEE HWY SUITE 63D
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City | FAIRFAX
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State | VA
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Zip | 22030-2428
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Country | US
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Telephone | 703-599-1478
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Fax |
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Provider Business Mailing Address
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Address Line | 706 N ARMISTEAD ST
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City | ALEXANDRIA
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State | VA
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Zip | 22312-2937
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Country | US
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Telephone | 703-333-5328
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0701003520
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717001065
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License Number State | VA
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