MR. JERRY EDWARD PARK LPC NPI 1457381360

NPI Information

NPI: 1457381360
Provider Name: MR. JERRY EDWARD PARK, LPC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
184 BUSINESS PARK DRIVE
SUITE 200
VIRGINIA BEACH, VA
ZIP 23462
Phone: (757) 466-3336
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MR. Jerry Edward Park, LPC is a mental health counselor in Virginia Beach, VA. MR. Jerry Edward Park, LPC NPI is 1457381360. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

184 BUSINESS PARK DRIVE
SUITE 200
VIRGINIA BEACH, VA
ZIP 23462-533
Phone: (757) 466-3336
Fax: (757) 455-5750

The enumeration date for this NPI number is 7/4/2006 and was last updated on 9/24/2009.

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	101YP2500X	Counselor	Professional	0701002010	VIRGINIA	No
2	101YM0800X	Counselor	Mental Health	701002010	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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