GABRIELLA T JACK NCC LPC NPI 1174116248

NPI Information

NPI: 1174116248
Provider Name: GABRIELLA T JACK, NCC, LPC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
9301 SANTAYANA DR
FAIRFAX, VA
ZIP 22031
Phone: (571) 502-8362
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Gabriella T Jack, NCC, LPC is a mental health counselor in Fairfax, VA. Gabriella T Jack, NCC, LPC NPI is 1174116248. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9301 SANTAYANA DR
FAIRFAX, VA
ZIP 22031-069
Phone: (571) 502-8362

The enumeration date for this NPI number is 2/18/2021 and was last updated on 2/18/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	0701010212	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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