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NPI Code Detail

MEDICARE: MISS JENNIFER ROSS WOODSON LCMHC

MEDICARE: MISS JENNIFER ROSS WOODSON LCMHC
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
1101YM0800XMental Health Counselor10762NC
2101Y00000XCounselorA10762NC

General Provider Information

NPI Number : 1245620061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER ROSS WOODSON LCMHC
Provider Business Mailing Address
First Line : 1708 TRAWICK RD STE 101
Second Line :
City : RALEIGH
State : NC
Zip : 27604-3897
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8045 ARCO CORPORATE DR STE 120
Second Line :
City : RALEIGH
State : NC
Zip : 27617-2026
Country : US
Telephone Number : 919-372-3690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2015
Last Update Date : 06/28/2024

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Directions to “ MISS JENNIFER ROSS WOODSON LCMHC” Practice Location

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