Provider Demographics
NPI:1316288095
Name:WARE-JONDREAU, JAMIE (LPC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:WARE-JONDREAU
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 1:1307 JAMESTOWN RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-3392
Mailing Address - Country:US
Mailing Address - Phone:757-229-7927
Mailing Address - Fax:757-253-8891
Practice Address - Street 1:1307 JAMESTOWN RD STE 202
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3392
Practice Address - Country:US
Practice Address - Phone:757-229-7927
Practice Address - Fax:757-253-8891
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005055101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1316288095Medicaid