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Individual

JODI LATOYA HERNDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, LSATP, CSAC

Contact information

Practice address
1110 ROSE HILL DR, SUITE 201, CHARLOTTESVILLE, VA 22903
(540) 840-6763
Mailing address
PO BOX 811, ORANGE, VA 22960-0474

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0718000425
VA
101YP2500X
Professional Counselor
Primary
0701008841
VA

Other

Enumeration date
08/18/2020
Last updated
08/19/2020
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