1427598549 NPI number — DR. KATHERINE ANN LEONBERGER STEIN PSY D

Table of content: DR. KATHERINE ANN LEONBERGER STEIN PSY D (NPI 1427598549)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427598549 NPI number — DR. KATHERINE ANN LEONBERGER STEIN PSY D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEIN
Provider First Name:
KATHERINE
Provider Middle Name:
ANN LEONBERGER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEONBERGER
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSY D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427598549
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/24/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8381 OLD COURTHOUSE ROAD
Provider Second Line Business Mailing Address:
SUITE 330
Provider Business Mailing Address City Name:
VIENNA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22182
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-938-9090
Provider Business Mailing Address Fax Number:
703-938-9091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8381 OLD COURTHOUSE ROAD
Provider Second Line Business Practice Location Address:
SUITE 330
Provider Business Practice Location Address City Name:
VIENNA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22182
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-938-9090
Provider Business Practice Location Address Fax Number:
703-938-9091
Provider Enumeration Date:
03/08/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  0810005480 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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