Provider Demographics
NPI:1003825084
Name:JENNINGS, LAUREN P (LPC, LMFT, CEAP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:P
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LPC, LMFT, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N CENTER DR SUITE 141
Mailing Address - Street 2:INTERSTATE CORPORATE CENTER BUILDING 11
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502
Mailing Address - Country:US
Mailing Address - Phone:757-466-0700
Mailing Address - Fax:757-461-4826
Practice Address - Street 1:420 N CENTER DR SUITE 141
Practice Address - Street 2:INTERSTATE CORPORATE CENTER BUILDING 11
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502
Practice Address - Country:US
Practice Address - Phone:757-466-0700
Practice Address - Fax:757-461-4826
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000688101Y00000X
VA0717000460106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist