Provider Demographics
NPI:1811625601
Name:SEDOR, JEANNETTE (LPC)
Entity type:Individual
Prefix:MS
First Name:JEANNETTE
Middle Name:
Last Name:SEDOR
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 1:3515 BOWLAND RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-3323
Mailing Address - Country:US
Mailing Address - Phone:804-647-9633
Mailing Address - Fax:
Practice Address - Street 1:3515 BOWLAND RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-3323
Practice Address - Country:US
Practice Address - Phone:804-647-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011369101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health