Healthcare Provider Details

I. General information

NPI: 1578912689
Provider Name (Legal Business Name): JENNIFER L WILLIAMS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4429 BONNEY RD STE 120
VIRGINIA BEACH VA
23462-3876
US

IV. Provider business mailing address

4310 METRO PKWY STE 205
FORT MYERS FL
33916-9416
US

V. Phone/Fax

Practice location:
  • Phone: 757-606-1377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701006600
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: