Provider Demographics
NPI:1073708053
Name:BELK, JESSICA RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENEE
Last Name:BELK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13454 NAYLORS BLUE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2908
Mailing Address - Country:US
Mailing Address - Phone:804-243-5159
Mailing Address - Fax:
Practice Address - Street 1:2663 OSBORNE RD STE 1
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-2168
Practice Address - Country:US
Practice Address - Phone:804-243-5159
Practice Address - Fax:804-597-0240
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040066271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical