Kathleen Denise Mikkelsen, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701006940 Issued in VA

Practice address

9560 Linton Hall Rd
Bristow, VA 20136-1218

Phone

(703) 989-3016

Fax

(703) 972-2240

NPI assigned

Jan 30, 2017

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

Electronic endpoints 1

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": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1437696341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10060 NAUGHTON CT",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201363068",
            "telephone_number": "703-989-3016",
            "fax_number": "703-972-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9560 LINTON HALL RD",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361218",
            "telephone_number": "703-989-3016",
            "fax_number": "703-972-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELSEN",
        "first_name": "KATHLEEN",
        "middle_name": "DENISE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701006940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kathleen@kathleenmikkelsenlpc.com",
            "affiliation": "N",
            "address_1": "9560 Linton Hall Rd",
            "city": "Bristow",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201361218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.