Healthcare Provider Details

I. General information

NPI: 1508684069
Provider Name (Legal Business Name): LATASHA PATRICE JONES-PATTERSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 FIRST COLONIAL RD STE A
VIRGINIA BEACH VA
23454-3078
US

IV. Provider business mailing address

1020 FIRST COLONIAL RD STE A
VIRGINIA BEACH VA
23454-3078
US

V. Phone/Fax

Practice location:
  • Phone: 757-395-5342
  • Fax: 757-222-5095
Mailing address:
  • Phone: 757-395-5342
  • Fax: 757-222-5095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017459
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: