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Individual

JON M. WARREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
224 GREAT BRIDGE BLVD., CHESAPEAKE, VA 23320
(757) 547-9334
(757) 819-6292
Mailing address
224 GREAT BRIDGE BLVD., CHESAPEAKE, VA 23320
(757) 547-9334
(757) 819-6292

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710101681
VA
101YM0800X
Mental Health Counselor
Primary
0701004463
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0805277M
OPTIMA/SENTARA
VA
01
1265733091
ANTHEM TRIGON
VA
05
1265733091
VA
Enumeration date
11/10/2010
Last updated
09/05/2013
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