Provider Demographics
NPI:1851523187
Name:HURSEY-WINGATE, JONI SUE (LPC)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:SUE
Last Name:HURSEY-WINGATE
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 1:1341 WHITE MARLIN LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-6342
Mailing Address - Country:US
Mailing Address - Phone:757-773-9511
Mailing Address - Fax:
Practice Address - Street 1:4310 INDIAN RIVER RD
Practice Address - Street 2:SUITE 4
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-3100
Practice Address - Country:US
Practice Address - Phone:757-963-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004622101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional