Provider Demographics
NPI:1457169195
Name:NESTLING SPARROW
Entity type:Organization
Organization Name:NESTLING SPARROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LAKIEYRA
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-977-9765
Mailing Address - Street 1:3900 WESTERRE PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1339
Mailing Address - Country:US
Mailing Address - Phone:757-977-9765
Mailing Address - Fax:
Practice Address - Street 1:3900 WESTERRE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1339
Practice Address - Country:US
Practice Address - Phone:757-977-9765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPRC200002119OtherLICENSE PROFESSIONAL COUNSELOR
VA0701013486OtherLICENSE PROFESSIONAL COUNSELOR
MDLC15693OtherLICENSE CLINICAL PROFESSIONAL COUNSELOR