Kimberly N Van Etten, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701010657 Issued in VA

Practice address

170 W Main St Ste B6
Purcellville, VA 20132-5829

Phone

(678) 520-0327

NPI assigned

Aug 24, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1346917820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 223",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201340223",
            "telephone_number": "678-520-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 W MAIN ST STE B6",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201325829",
            "telephone_number": "678-520-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ETTEN",
        "first_name": "KIMBERLY",
        "middle_name": "N",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701010657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Purcellville, VA
• Providers in Purcellville, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.