Provider Demographics
NPI:1710466354
Name:MORGAN, JENNIFER CORTES (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CORTES
Last Name:MORGAN
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 1:355 CRAWFORD ST STE 816
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-2825
Mailing Address - Country:US
Mailing Address - Phone:757-966-2715
Mailing Address - Fax:757-432-2971
Practice Address - Street 1:355 CRAWFORD ST STE 816
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2825
Practice Address - Country:US
Practice Address - Phone:757-966-2715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007767101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA601309670Medicaid