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General NPI Number Information
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NPI Number | 1134736747
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Entity Type | Organization
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Legal Business Name | JENNIFER VIRGO THERAPY, PLLC
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 3902 14TH ST NW APT 621
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City | WASHINGTON
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State | DC
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Zip | 20011-5444
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Country | US
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Telephone | 703-395-3032
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Fax |
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Provider Business Mailing Address
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Address Line | 3902 14TH ST NW APT 621
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City | WASHINGTON
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State | DC
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Zip | 20011-5444
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Country | US
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Telephone | 703-395-3032
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | JENNIFER VIRGO
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Credential | LICSW, LCSW-C, LCSW
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Telephone | 703-395-3032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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