Provider Demographics
NPI:1306326632
Name:STEPP, JENNIFER TAYLOR
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:TAYLOR
Last Name:STEPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 HOLLAND LN
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:VA
Mailing Address - Zip Code:23487-9216
Mailing Address - Country:US
Mailing Address - Phone:757-613-8189
Mailing Address - Fax:
Practice Address - Street 1:105 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1701
Practice Address - Country:US
Practice Address - Phone:757-516-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007821101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional