Provider Demographics
NPI:1447309943
Name:KIRK, GINGER LYNNE (LPC)
Entity type:Individual
Prefix:DR
First Name:GINGER
Middle Name:LYNNE
Last Name:KIRK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4551 INTERLACHEN CT APT E
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-3212
Mailing Address - Country:US
Mailing Address - Phone:703-231-6161
Mailing Address - Fax:
Practice Address - Street 1:8348 TRAFORD LN
Practice Address - Street 2:SUITE 400
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1663
Practice Address - Country:US
Practice Address - Phone:703-866-2102
Practice Address - Fax:703-451-7539
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003136101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701003136OtherL. P.C.