Provider Demographics
NPI:1235762659
Name:MAGORIAN, JESSICA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:MAGORIAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-1239
Mailing Address - Country:US
Mailing Address - Phone:540-663-3322
Mailing Address - Fax:540-663-2947
Practice Address - Street 1:16495 15TH ST
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-6218
Practice Address - Country:US
Practice Address - Phone:540-663-3322
Practice Address - Fax:540-663-2947
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPPS-06059971041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool