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General NPI Number Information
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NPI Number | 1497110548
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Entity Type | Individual
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Provider Name | FREDERICA JONES LPC
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Gender | Female
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 1216 GRANBY ST SUITE 213
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City | NORFOLK
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State | VA
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Zip | 23510-2607
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Country | US
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Telephone | 757-963-6303
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Fax |
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Provider Business Mailing Address
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Address Line | 600 WESTOVER AVE #3
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City | NORFOLK
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State | VA
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Zip | 23507-1741
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Country | US
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Telephone | 757-513-2453
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701006251
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License Number State | VA
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