Provider Demographics
NPI:1497110548
Name:JONES, FREDERICA (LPC)
Entity Type:Individual
Prefix:
First Name:FREDERICA
Middle Name:
Last Name:JONES
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 1:600 WESTOVER AVE
Mailing Address - Street 2:#3
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1741
Mailing Address - Country:US
Mailing Address - Phone:757-513-2453
Mailing Address - Fax:
Practice Address - Street 1:1216 GRANBY ST
Practice Address - Street 2:SUITE 213
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2607
Practice Address - Country:US
Practice Address - Phone:757-963-6303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006251101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health