Provider Demographics
NPI:1508581455
Name:JENNIFER LANOUETTE LCSW
Entity Type:Organization
Organization Name:JENNIFER LANOUETTE LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LANOUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-981-9070
Mailing Address - Street 1:304 S HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-2054
Mailing Address - Country:US
Mailing Address - Phone:703-981-9070
Mailing Address - Fax:
Practice Address - Street 1:105 N VIRGINIA AVE STE 306
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3342
Practice Address - Country:US
Practice Address - Phone:703-981-9070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty