Individual provider Active NPI

Kathryn Deloose, LCPC

  • Mental Health Counselor
  • Arlington, VA
National Provider Identifier
1538645593
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701011342 Issued in VA
Practice address
5953 10TH Rd N
Arlington, VA 22205-1636
Phone
(681) 222-0504
NPI assigned
Jul 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC8519 MD
Clinical Social Worker 1041C0700X LC8519 MD
Mental Health Counselor 101YM0800X 0701011342 VA Primary

Addresses

Primary practice location

5953 10TH Rd N
Arlington, VA 22205-1636

Mailing address

5953 10TH Rd N
Arlington, VA 22205-1636
Phone (681) 222-0504

Other names 1

  • Kathryn Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701011342VAMDMental Health Counselor
LC8519MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1538645593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5953 10TH RD N",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222051636",
            "telephone_number": "681-222-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5953 10TH RD N",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222051636",
            "telephone_number": "681-222-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOOSE",
        "first_name": "KATHRYN",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC8519",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "LC8519",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701011342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "DAVIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.