Healthcare Provider Details

I. General information

NPI: 1477033561
Provider Name (Legal Business Name): JILL PARRAMORE LPC, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12695 MCMANUS BLVD
NEWPORT NEWS VA
23602-4435
US

IV. Provider business mailing address

104 BRANTLEY CT
YORKTOWN VA
23693-5709
US

V. Phone/Fax

Practice location:
  • Phone: 757-877-7700
  • Fax:
Mailing address:
  • Phone: 757-230-3168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0701007528
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0710103177
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: