Provider Demographics
NPI:1083341002
Name:STANLEY, JAYE LYNN (LPC)
Entity type:Individual
Prefix:
First Name:JAYE
Middle Name:LYNN
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 LAKE POWELL RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-3721
Mailing Address - Country:US
Mailing Address - Phone:757-646-8845
Mailing Address - Fax:
Practice Address - Street 1:3204 IRONBOUND RD STE D
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2410
Practice Address - Country:US
Practice Address - Phone:757-274-9354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-01
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional