Individual
MR. JOHN JEFFREY WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
9244 ST CHARLES CIR, RICHMOND, VA 23235-2413
(804) 874-5393
Mailing address
9244 ST CHARLES CIR, RICHMOND, VA 23235-2413
(804) 874-5393
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002484
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008937346
—
VA
Enumeration date
05/31/2006
Last updated
06/25/2026
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