Provider Demographics
NPI:1013587427
Name:PIPOLO, JENNA M (LPC)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:M
Last Name:PIPOLO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 LYNNHAVEN PKWY STE 340
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7361
Mailing Address - Country:US
Mailing Address - Phone:757-694-4723
Mailing Address - Fax:757-301-8803
Practice Address - Street 1:780 LYNNHAVEN PKWY STE 340
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7361
Practice Address - Country:US
Practice Address - Phone:757-694-4723
Practice Address - Fax:757-301-8803
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010610101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30017641610003Medicaid