Provider Demographics
NPI:1588542831
Name:KITCHEN, NICOLE ELIZABETH ALLAN
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ELIZABETH ALLAN
Last Name:KITCHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 G ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2724
Mailing Address - Country:US
Mailing Address - Phone:703-746-3400
Mailing Address - Fax:
Practice Address - Street 1:4850 MARK CENTER DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1882
Practice Address - Country:US
Practice Address - Phone:703-746-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040184391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical