MEDICARE: JENAY GARRETT LPC

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	0701007401	VA
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1558860585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENAY GARRETT LPC

Provider Business Mailing Address
First Line	:	1385 FORDHAM DR STE 105-190
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-5345
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1385 FORDHAM DR STE 105-190
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-5345
Country	:	US
Telephone Number	:	579-572-5947
Fax Number	:

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

Provider Enumeration Date	:	02/05/2018
Last Update Date	:	08/08/2024

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