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General NPI Number Information
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NPI Number | 1619513090
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Entity Type | Individual
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Provider Name | JAMERE WOODY LPC-R, RIC
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Gender | Male
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 200 FARADAY PLZ
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City | WINCHESTER
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State | VA
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Zip | 22603-4669
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Country | US
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Telephone | 866-934-7450
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 MONTGOMERY RD STE 400
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City | CINCINNATI
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State | OH
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Zip | 45212-2600
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0704017150
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License Number State | VA
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