Healthcare Provider Details

I. General information

NPI: 1003729880
Provider Name (Legal Business Name): JEFF MAZZONE COUNSELING & SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1671 EMANCIPATION HWY STE 105
FREDERICKSBURG VA
22401-4668
US

IV. Provider business mailing address

1671 EMANCIPATION HWY STE 105
FREDERICKSBURG VA
22401-4668
US

V. Phone/Fax

Practice location:
  • Phone: 540-277-0196
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY THOMAS MAZZONE
Title or Position: OWNER & FOUNDER
Credential: MA, LPC, MA
Phone: 475-289-6628