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NPI Code Detail

MEDICARE: MS. JENNIFER MARIE HARRISON MS, CRC

MEDICARE: MS. JENNIFER MARIE HARRISON MS, CRC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor0701011266VA
2101YA0400XAddiction (Substance Use Disorder) Counselor
3101YP2500XProfessional Counselor0701011266VA

General Provider Information

NPI Number : 1346755758
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER MARIE HARRISON MS, CRC
Provider Business Mailing Address
First Line : 9609 JEFFERSON DAVIS HWY
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23237-4621
Country : US
Telephone Number : 804-275-1116
Fax Number : 804-275-1850
Provider Business Practice Location Address
First Line : 9609 JEFFERSON DAVIS HWY
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23237-4621
Country : US
Telephone Number : 804-275-1116
Fax Number : 804-275-1850
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2017
Last Update Date : 03/24/2022

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