Provider Demographics
NPI:1376901223
Name:JATAU, ZAMWAWOSAYI (LPC)
Entity Type:Individual
Prefix:MR
First Name:ZAMWAWOSAYI
Middle Name:
Last Name:JATAU
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 OFFICE SQUARE LN
Mailing Address - Street 2:SUITE 104
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3648
Mailing Address - Country:US
Mailing Address - Phone:757-559-1773
Mailing Address - Fax:
Practice Address - Street 1:328 OFFICE SQUARE LN
Practice Address - Street 2:SUITE 104
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3648
Practice Address - Country:US
Practice Address - Phone:757-559-1773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-07
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005514101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional