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General NPI Number Information
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NPI Number | 1770170730
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Entity Type | Organization
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Legal Business Name | THE LAMP COUNSELING CENTER
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Dates
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Enumeration Date | 12/24/2020
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Last Update Date | 12/24/2020
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Provider Practice Location Address
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Address Line | 16178 RAPTOR CREST LN
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City | WOODBRIDGE
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State | VA
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Zip | 22193-5794
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Country | US
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Telephone | 610-470-6613
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Fax |
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Provider Business Mailing Address
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Address Line | 16178 RAPTOR CREST LN
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City | WOODBRIDGE
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State | VA
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Zip | 22193-5794
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Country | US
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Telephone | 610-470-6613
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Fax |
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Authorized Official
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Title or Position | OWNER, PROVIDER
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Name | JESSICA JEMMOTT
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Credential | MA, LPC
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Telephone | 610-470-6613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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