Kiersten Farrell, LPC, LSATP
Individual provider Active NPI Mental Health Counselor · Clifton, VA
NPI 1508577453 · NPPES record last updated Sep 23, 2023
Key facts
- NPI
- 1508577453
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 0701012520 (VA)
- Practice address
- 13410 Trey LN
Clifton, VA 20124-0923 - Phone
- (703) 217-8134
- NPI assigned
- Dec 12, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0718000613 | VA | MD | Addiction (Substance Use Disorder) Counselor |
| 0701012520 | VA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S.T.E.P. Into Wellness, LLC | Current |
Accepting new patients | |
| Infinite Wellness, LLC | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Locations
9110 Railroad Dr
Ste 310A
Manassas Park, VA 20111
Phone (703) 334-1801
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0701012520 | VA | Yes |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0718000613 | VA |
Addresses
Primary practice location
13410 Trey LN
Clifton, VA 20124-0923
Mailing address
13410 Trey LN
Clifton, VA 20124-0923
Phone (703) 217-8134
Other practice location 1
9110 Railroad Dr Ste 310A
Manassas Park, VA 20111-7042
Phone (703) 334-2206
Other providers in Clifton, VA
- Gale Otello Cleveland
- Morgan Cripe
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- Deborah Chung, D.D.S., PLLC
- Jessica Dye
- Kimberly Federico
- Footprints Behavior Services LLC
- Michele Renee Galindo
- Meghan Allyn Ashley Ganzaba
- Diana Gaydusek
All providers in Clifton, VA · Mental Health Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.