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General NPI Number Information
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NPI Number | 1346501996
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Entity Type | Individual
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Provider Name | JESSICA F SUMMERS M.S.W,, L.C.S.W
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Gender | Female
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 09/25/2018
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Provider Practice Location Address
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Address Line | 9327 MIDLOTHIAN TPKE STE G
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4964
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Country | US
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Telephone | 804-277-9034
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Fax | 804-418-3765
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Provider Business Mailing Address
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Address Line | 2110 BARCLAY RD
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City | RICHMOND
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State | VA
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Zip | 23228-6022
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Country | US
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Telephone | 804-277-9034
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904007055
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License Number State | VA
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