Provider Demographics
NPI:1326053026
Name:RACER, JAIME BETH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:BETH
Last Name:RACER
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 1:12721 DARBY BROOK CT
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2408
Mailing Address - Country:US
Mailing Address - Phone:703-497-1771
Mailing Address - Fax:703-497-1225
Practice Address - Street 1:12721 DARBY BROOK CT
Practice Address - Street 2:SUITE 102
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2408
Practice Address - Country:US
Practice Address - Phone:703-497-1771
Practice Address - Fax:703-497-1225
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003856101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health