Provider Demographics
NPI:1932162211
Name:ASHBURNE, JANNIE HOLLOWAY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JANNIE
Middle Name:HOLLOWAY
Last Name:ASHBURNE
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 1:904 APPLE GROVE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-5930
Mailing Address - Country:US
Mailing Address - Phone:804-328-6410
Mailing Address - Fax:
Practice Address - Street 1:904 APPLE GROVE CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-5930
Practice Address - Country:US
Practice Address - Phone:804-328-6410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-08
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005411866Medicaid