Provider Demographics
NPI:1811292154
Name:PRESTON, JUDITH WAMBUI (LPC)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:WAMBUI
Last Name:PRESTON
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 1:224 GREAT BRIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3904
Mailing Address - Country:US
Mailing Address - Phone:757-547-9334
Mailing Address - Fax:757-819-6292
Practice Address - Street 1:816 GREENBRIER CIR STE 209
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2642
Practice Address - Country:US
Practice Address - Phone:757-818-5905
Practice Address - Fax:757-319-4347
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004803101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health