Provider Demographics
NPI:1437694312
Name:MCNEISH-EDGERTON, JOSLYNN
Entity Type:Individual
Prefix:
First Name:JOSLYNN
Middle Name:
Last Name:MCNEISH-EDGERTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOSLYNN
Other - Middle Name:LYNETTE
Other - Last Name:MCNEISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2007 APPLE ORCHARD CT
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5620
Mailing Address - Country:US
Mailing Address - Phone:804-901-5219
Mailing Address - Fax:
Practice Address - Street 1:2007 APPLE ORCHARD CT
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5620
Practice Address - Country:US
Practice Address - Phone:804-901-5219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-30
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000541101YA0400X
VA0701011693101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)