Provider Demographics
NPI:1861673477
Name:WEEKES, JENNIFER DONA (MSW, LICSW)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:DONA
Last Name:WEEKES
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15211 VALLEY STREAM DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3919
Mailing Address - Country:US
Mailing Address - Phone:571-276-5843
Mailing Address - Fax:
Practice Address - Street 1:15211 VALLEY STREAM DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3919
Practice Address - Country:US
Practice Address - Phone:571-276-5843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500784471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical