DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: DR. BONITA MARIE JACKSON-VERGARA LICENSED COUNSELOR

MEDICARE: DR. BONITA MARIE JACKSON-VERGARA LICENSED COUNSELOR
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
1101YA0400XAddiction (Substance Use Disorder) Counselor0718000386VA
2101YP2500XProfessional Counselor0701005902VA
3101YP2500XProfessional Counselor4804NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316967334
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BONITA MARIE JACKSON-VERGARA LICENSED COUNSELOR
Provider Business Mailing Address
First Line : 800 FOX RIDGE TRL
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23322-6506
Country : US
Telephone Number : 704-804-9614
Fax Number : 757-312-9580
Provider Business Practice Location Address
First Line : 1545 CROSSWAYS BLVD STE 250
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-0218
Country : US
Telephone Number : 704-804-9614
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 10/13/2021

Similar Medicare Providers

1285582247 — CLEMENTINE VIRGINIA ABA LLC
Practice Location Address:
1545 CROSSWAYS BLVD STE 250
CHESAPEAKE, VA
23320-0218
Practice Phone: 888-603-2536
Practice Fax:
1316435092 — ANDREA VISCARRA
Practice Location Address:
1545 CROSSWAYS BLVD STE 250
CHESAPEAKE, VA
23320-0218
Practice Phone: 571-765-5005
Practice Fax:
1740158468 — CLEARMIND SOLUTIONS LLC
Practice Location Address:
1545 CROSSWAYS BLVD STE 250
CHESAPEAKE, VA
23320-0218
Practice Phone: 757-447-4772
Practice Fax: 757-731-7222
1255287967 — MRS. GEORGETTE ROSETTE BULLOCK MSW
Practice Location Address:
1545 CROSSWAYS BLVD STE 250
CHESAPEAKE, VA
23320-0218
Practice Phone: 757-405-7210
Practice Fax: 757-802-4534
1295211316 — SOUTHSIDE SERVICES, LLC
Practice Location Address:
1545 CROSSWAYS BLVD STE 250
CHESAPEAKE, VA
23320-0218
Practice Phone: 757-309-1405
Practice Fax:
1093724940 — DENISE HALL PH.D.
Practice Location Address:
1545 CROSSWAYS BLVD STE 250
CHESAPEAKE, VA
23320-0218
Practice Phone: 757-206-2772
Practice Fax: 757-757-2962

Directions to “ DR. BONITA MARIE JACKSON-VERGARA LICENSED COUNSELOR” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.