MEDICARE: JEYLIM WAYNE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0701013932	VA

General Provider Information

NPI Number	:	1316581119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEYLIM WAYNE

Provider Business Mailing Address
First Line	:	4410 CLAIBORNE SQ E STE 218
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-2071
Country	:	US
Telephone Number	:	757-553-5375
Fax Number	:

Provider Business Practice Location Address
First Line	:	4410 CLAIBORNE SQ E
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-2071
Country	:	US
Telephone Number	:	757-553-5375
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2019
Last Update Date	:	02/12/2026

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Directions to “ JEYLIM WAYNE ” Practice Location

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