Healthcare Provider Details

I. General information

NPI: 1104492131
Provider Name (Legal Business Name): JOCETTA DENNIS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 N GLEBE RD STE 525
ARLINGTON VA
22201-5792
US

IV. Provider business mailing address

1005 N GLEBE RD STE 525
ARLINGTON VA
22201-5792
US

V. Phone/Fax

Practice location:
  • Phone: 804-207-6737
  • Fax:
Mailing address:
  • Phone: 804-207-6737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2022014707
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC200012507
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: