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Individual

JORDAN LAMONT COSTEN-SUMPTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5250 CHEROKEE AVE STE 497, ALEXANDRIA, VA 22312-2052
(404) 987-3768
Mailing address
8396 TENBROOK DR, GAINESVILLE, VA 20155-3877

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904017882
VA

Other

Enumeration date
02/06/2025
Last updated
02/06/2025
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