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General NPI Number Information
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NPI Number | 1932419405
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Entity Type | Individual
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Provider Name | WENDY A KRUPA LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 4229 LAFAYETTE CENTER DR STE 1200
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City | CHANTILLY
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State | VA
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Zip | 20151-1265
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Country | US
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Telephone | 571-340-2402
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Fax | 571-291-4141
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Provider Business Mailing Address
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Address Line | 40454 SOUSA PL
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City | ALDIE
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State | VA
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Zip | 20105-2392
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Country | US
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Telephone | 713-402-4025
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Fax | 571-291-4141
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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 | 054239
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License Number State | NY
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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 | 0904009040
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License Number State | VA
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