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General NPI Number Information
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NPI Number | 1679229231
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Entity Type | Individual
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Provider Name | REBECCA RIDOUT JONES LPC
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Gender | Female
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Dates
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Enumeration Date | 02/22/2022
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 3772 SHORE DR STE 3
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-2976
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Country | US
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Telephone | 757-644-1749
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Fax |
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Provider Business Mailing Address
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Address Line | 2202 WOOD IBIS WAY
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-1564
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Country | US
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Telephone | 757-319-0104
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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 | 0701009918
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License Number State | VA
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