Provider Demographics
NPI:1831648583
Name:Z. ANDREW JATAU MS, LPC LLC
Entity Type:Organization
Organization Name:Z. ANDREW JATAU MS, LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ZAMWAWOSAYI
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:JATAU
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:757-620-8539
Mailing Address - Street 1:328 OFFICE SQUARE LN
Mailing Address - Street 2:SUITE 104
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3648
Mailing Address - Country:US
Mailing Address - Phone:757-559-1773
Mailing Address - Fax:
Practice Address - Street 1:328 OFFICE SQUARE LN
Practice Address - Street 2:SUITE 104
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3648
Practice Address - Country:US
Practice Address - Phone:757-559-1773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005514251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health