Provider Demographics
NPI:1134674971
Name:DRAKE, JENELLE (MA, LMFT, LPC)
Entity Type:Individual
Prefix:
First Name:JENELLE
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:MA, LMFT, LPC
Other - Prefix:
Other - First Name:JENELLE
Other - Middle Name:MONET
Other - Last Name:DEBEAULIEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:309 WILLOW BEND CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-1057
Mailing Address - Country:US
Mailing Address - Phone:401-595-0624
Mailing Address - Fax:
Practice Address - Street 1:309 WILLOW BEND CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-1057
Practice Address - Country:US
Practice Address - Phone:401-595-0624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF8720106H00000X
VA0701010840101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist