Provider Demographics
NPI:1942855473
Name:FURINESS, JESSICA ANN (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:FURINESS
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 1:206 MARBLE RUN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5479
Mailing Address - Country:US
Mailing Address - Phone:757-254-8996
Mailing Address - Fax:
Practice Address - Street 1:921 CAPITOL LANDING RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-4348
Practice Address - Country:US
Practice Address - Phone:757-253-4074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional