Basic Information
| Provider Information | |||||||||
| NPI: | 1598107849 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEINHOLD | ||||||||
| FirstName: | CAITLYN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5999 BURKE COMMONS RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | BURKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220152880 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5999 BURKE COMMONS RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | BURKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220152880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032497200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2013 | ||||||||
| LastUpdateDate: | 06/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | PRC15416 | DC | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | LC10901 | MD | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 0701008397 | VA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.