Individual
MRS. BETTY JAYNE EASTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
370 WYTHE CREEK RD STE C, POQUOSON, VA 23662-1926
(757) 868-0072
(757) 868-0087
Mailing address
370 WYTHE CREEK RD STE C, SUITE C, POQUOSON, VA 23662-1926
(757) 868-0072
(757) 868-0087
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
9040004680
VA
1041C0700X
Clinical Social Worker
Primary
0904004680
VA
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010172314
—
VA
01
—
356288
BLUE CROSS BLUE SHIELD
VA
01
—
428878
TRICARE
VA
05
—
GC1022
—
VA
01
—
Q43454A
MEDICARE
VA
Enumeration date
03/14/2006
Last updated
05/04/2026
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