Provider Demographics
NPI:1477269801
Name:THE VIRTUOUS WOMAN INC
Entity Type:Organization
Organization Name:THE VIRTUOUS WOMAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:D
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:MCAP
Authorized Official - Phone:904-472-7233
Mailing Address - Street 1:PO BOX 12919
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-0919
Mailing Address - Country:US
Mailing Address - Phone:904-472-7233
Mailing Address - Fax:904-379-7987
Practice Address - Street 1:8298 FOURAKER FOREST RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-7688
Practice Address - Country:US
Practice Address - Phone:904-472-7233
Practice Address - Fax:904-379-7987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or Charitable
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health