Provider Demographics
NPI:1659257962
Name:KIRK, TARYN BRITTANY (LMHP-R)
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:BRITTANY
Last Name:KIRK
Suffix:
Gender:F
Credentials:LMHP-R
Other - Prefix:
Other - First Name:TARYN
Other - Middle Name:KIRK
Other - Last Name:MAZIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21033 ASHBURN HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4476
Mailing Address - Country:US
Mailing Address - Phone:703-220-9340
Mailing Address - Fax:
Practice Address - Street 1:20384 MEDALIST DR
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4186
Practice Address - Country:US
Practice Address - Phone:703-220-9340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704017372101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor