Provider Demographics
NPI:1962883702
Name:GUERIN, JENNIFER ROBINSON
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROBINSON
Last Name:GUERIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4410 VIRGINIA BYWAY
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-4737
Mailing Address - Country:US
Mailing Address - Phone:717-648-9859
Mailing Address - Fax:
Practice Address - Street 1:4410 VIRGINIA BYWAY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-4737
Practice Address - Country:US
Practice Address - Phone:540-583-6625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006156101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional