Provider Demographics
NPI:1437513249
Name:KLOSTERMAN, RENATA (MA,NCC,LPC,CSAC)
Entity type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:KLOSTERMAN
Suffix:
Gender:F
Credentials:MA,NCC,LPC,CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-2609
Mailing Address - Country:US
Mailing Address - Phone:540-727-0770
Mailing Address - Fax:540-727-7310
Practice Address - Street 1:605 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-2609
Practice Address - Country:US
Practice Address - Phone:540-727-0770
Practice Address - Fax:540-727-7310
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710102864101YA0400X
VA0701006570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)