Healthcare Provider Details

I. General information

NPI: 1558973552
Provider Name (Legal Business Name): JONATHAN HUFFMAN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 E MARKET ST
HARRISONBURG VA
22801-4241
US

IV. Provider business mailing address

590 E MARKET ST
HARRISONBURG VA
22801-4241
US

V. Phone/Fax

Practice location:
  • Phone: 540-692-5234
  • Fax: 540-215-7196
Mailing address:
  • Phone: 540-692-5234
  • Fax: 540-215-7196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701009779
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: