Healthcare Provider Details

I. General information

NPI: 1285227884
Provider Name (Legal Business Name): FRIENDLY CITY PSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2021
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N HIGH ST
HARRISONBURG VA
22802-3826
US

IV. Provider business mailing address

225 N HIGH ST
HARRISONBURG VA
22802-3826
US

V. Phone/Fax

Practice location:
  • Phone: 540-209-8182
  • Fax: 888-854-5854
Mailing address:
  • Phone: 540-209-8182
  • Fax: 888-854-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JERROD ANTHONY KOON
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 540-209-8182