Provider Demographics
NPI:1578194643
Name:OBERLANDER, KRISTA (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:OBERLANDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 N ROYAL ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2629
Mailing Address - Country:US
Mailing Address - Phone:703-472-6291
Mailing Address - Fax:
Practice Address - Street 1:3330 WASHINGTON BLVD STE 150
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-4502
Practice Address - Country:US
Practice Address - Phone:703-472-6291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040036771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical