Provider Demographics
NPI:1316091812
Name:ALBRACHT, KARLA TERESA (LICENSED CLERICAL SO)
Entity type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:TERESA
Last Name:ALBRACHT
Suffix:
Gender:F
Credentials:LICENSED CLERICAL SO
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:TERESA
Other - Last Name:JEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5305 ORCHARDSON COURT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10560 MAIN STREET
Practice Address - Street 2:SUITE #410
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030
Practice Address - Country:US
Practice Address - Phone:703-352-8538
Practice Address - Fax:703-352-9040
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040050391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical