Provider Demographics
NPI:1679229231
Name:JONES, REBECCA RIDOUT (LPC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:RIDOUT
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 1:2202 WOOD IBIS WAY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-1564
Mailing Address - Country:US
Mailing Address - Phone:757-319-0104
Mailing Address - Fax:
Practice Address - Street 1:3772 SHORE DR STE 3
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-2976
Practice Address - Country:US
Practice Address - Phone:757-644-1749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009918101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health