Healthcare Provider Details

I. General information

NPI: 1710842158
Provider Name (Legal Business Name): JADA NOGGLE LCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JADA ALDRIDGE

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 INDEPENDENCE PKWY STE 240
CHESAPEAKE VA
23320-5222
US

IV. Provider business mailing address

2202 EXECUTIVE DR STE C
HAMPTON VA
23666-6604
US

V. Phone/Fax

Practice location:
  • Phone: 757-965-5886
  • Fax:
Mailing address:
  • Phone: 757-827-7707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810009234
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: