Provider Demographics
NPI:1992351167
Name:GAMBLE, JANAE HARRIETT (LMFT)
Entity type:Individual
Prefix:
First Name:JANAE
Middle Name:HARRIETT
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6603 IRONGATE SQ
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-6081
Mailing Address - Country:US
Mailing Address - Phone:804-743-0960
Mailing Address - Fax:
Practice Address - Street 1:800 NEWTOWN RD STE 104
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1265
Practice Address - Country:US
Practice Address - Phone:757-974-1469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001566106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist