Healthcare Provider Details

I. General information

NPI: 1497557839
Provider Name (Legal Business Name): JENNA ELIZABETH MEYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6862 ELM ST STE 620
MCLEAN VA
22101-3862
US

IV. Provider business mailing address

6862 ELM ST STE 620
MCLEAN VA
22101-3862
US

V. Phone/Fax

Practice location:
  • Phone: 703-232-6102
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0730000771
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: