Provider Demographics
NPI:1982199006
Name:JARBOE, CAROL (LPC, NCC, MA)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:JARBOE
Suffix:
Gender:F
Credentials:LPC, NCC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10707 SIMPSON MEWS LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-8136
Mailing Address - Country:US
Mailing Address - Phone:703-989-4404
Mailing Address - Fax:
Practice Address - Street 1:9675 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3762
Practice Address - Country:US
Practice Address - Phone:703-989-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-30
Last Update Date:2018-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007616101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701007616OtherSTATE LICENSE