Provider Demographics
NPI:1992287833
Name:ATANASOV, KATHRYN GOSS (PHD, LPC, NCC, CSAC)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:GOSS
Last Name:ATANASOV
Suffix:
Gender:F
Credentials:PHD, LPC, NCC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3493 FRANCES BERKELEY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-1334
Mailing Address - Country:US
Mailing Address - Phone:757-232-7108
Mailing Address - Fax:
Practice Address - Street 1:FARLEY IOP WILLIAMSBURG PLACE
Practice Address - Street 2:5477 MOORETOWN ROAD
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188
Practice Address - Country:US
Practice Address - Phone:757-280-1194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710103039101YA0400X
VA0701007579101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)