Healthcare Provider Details

I. General information

NPI: 1720870173
Provider Name (Legal Business Name): JESSICA LEIGHANN HUFFMAN LPC, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 COURTHOUSE DR
VIRGINIA BEACH VA
23456-9121
US

IV. Provider business mailing address

2405 COURTHOUSE DR
VIRGINIA BEACH VA
23456-9121
US

V. Phone/Fax

Practice location:
  • Phone: 757-708-2936
  • Fax:
Mailing address:
  • Phone: 757-708-2936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701013190
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: