MEDICARE: JENNIFER SECRETI LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701015613	VA

General Provider Information

NPI Number	:	1124987177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER SECRETI LPC

Provider Business Mailing Address
First Line	:	12414 BRANNER PL APT 302
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-2798
Country	:	US
Telephone Number	:	315-254-6111
Fax Number	:

Provider Business Practice Location Address
First Line	:	12414 BRANNER PL APT 302
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-2798
Country	:	US
Telephone Number	:	315-254-6111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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