Provider Demographics
NPI:1558973552
Name:HUFFMAN, JONATHAN (LPC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:HUFFMAN
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 1:124 VALLEY VISTA DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664-1608
Mailing Address - Country:US
Mailing Address - Phone:540-459-1700
Mailing Address - Fax:540-459-1809
Practice Address - Street 1:124 VALLEY VISTA DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1608
Practice Address - Country:US
Practice Address - Phone:540-459-9373
Practice Address - Fax:540-459-1809
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009779101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional