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Individual

JANE L SIRKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
22280 JEB STUART HWY, STUART, VA 24171-2999
(276) 694-4570
(276) 694-3445
Mailing address
24 CLAY ST, MARTINSVILLE, VA 24112-2810
(276) 632-7128
(276) 632-0127

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701005369
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004945221
MEDICAID # FOR GROUP
VA
Enumeration date
12/11/2012
Last updated
12/11/2012
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