MR. JERRY EDWARD PARK (NPI# 1457381360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457381360 |
| Entity Type | Individual |
| Full Name | MR. JERRY EDWARD PARK |
| Credential | LPC |
| Practice Address |
184 Business Park Drive Suite 200 Virginia Beach VA 23462-6533 |
| Practice Telephone | 7574663336 |
| Practice Fax Number | 7574555750 |
| Mailing Telephone | 7574663336 |
| Mailing Fax Number | 7574555750 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2009-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
701002010 | VA | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
0701002010 | VA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235254095 | Jerry B Park | Optometrist | 291 North First Street, Jacksonville, AR 72076 | 2007-03-20 |
| 1588707764 | Jerry Park | Chiropractor | 224 S Main St Ste 1, Centerville, UT 84014-2206 | 2007-02-15 |
| 1245337153 | Jerry W. Park | Family Medicine | 9222 N Newport Hwy, Ste 1, Spokane, WA 99218-1235 | 2006-09-20 |
| Street Address |
184 BUSINESS PARK DRIVE SUITE 200 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23462-6533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962653436 | Community Direct Services, Inc. | Respite Care | 184 Business Park Drive, Suite 125, Virginia Beach, VA 23462 | 2008-10-02 |
| 1437337714 | James W Cheshire | Counselor | 184 Business Park Drive, Suite 200, Virginia Beach, VA 23462-6533 | 2008-02-08 |
| 1689713703 | Community Direct Services, Inc. | Hospice Care, Community Based | 184 Business Park Drive, Suite 125, Virginia Beach, VA 23462 | 2007-02-05 |
| 1386798585 | Ramona Douthit | Counselor | 184 Business Park Drive, Suite 200, Virginia Beach, VA 23462-6533 | 2007-01-23 |
| 1154413086 | Joy M Bankart | Counselor | 184 Business Park Drive, Suite 200, Virginia Beach, VA 23462-6533 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912534082 | Cheyenne James | Counselor | 297 Independence Blvd., Virginia Beach, VA 23462 | 2020-03-26 |
| 1245871011 | Marathon Transportation Services LLC | Non-emergency Medical Transport (VAN) | 4505 Main Street, Apt 259, Virginia Beach, VA 23462 | 2019-10-03 |
| 1003475153 | Keyuri S Shah | Physical Therapist | 5701 Cleveland St, Ste 600, Virginia Beach, VA 23462 | 2019-06-12 |
| 1629561329 | Mary Katherine Pratt | Physician Assistant | 828 Healthy Way Ste 350, Virginia Beach, VA 23462 | 2018-06-07 |
| 1801387808 | Matrixx Healthcare LLC | Respite Care | 405 S Parliament Dr Ste 106, Virginia Beach, VA 23462 | 2018-05-24 |
| 1518471671 | Newtown Chiropractic Center Pllc | Clinic/Center | 5777 Princess Ann Road, Virginia Beach, VA 23462 | 2017-11-28 |
| 1528587995 | Gary Lee Alexander II | Counselor | 870 N Newtown Road, Virginia Beach, VA 23462 | 2017-09-16 |
| 1801328810 | Servitium Med Va, LLC | Durable Medical Equipment & Medical Supplies | 4445 Corporation Lane Suite 291, Virginia Beach, VA 23462 | 2017-03-29 |
| 1215476171 | Johnnie Walter Cox IIi | Emergency Medical Technician, Basic | 5163 Cleveland Street, Virginia Beach, VA 23462 | 2017-02-13 |
| 1225570179 | Holly Balsamo | Occupational Therapy Assistant | 5345 Marian Lane, Virginia Beach, VA 23462 | 2016-11-09 |
| Find all providers in zip 23462 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356941181 | Amy H Drescher LLC | Counselor | 3615 Atlantic Ave Apt 302, Virginia Beach, VA 23451-2749 | 2020-10-30 |
| 1629678735 | Stephanie Ellzey | Counselor | 4169 Virginia Beach Blvd Ste 150, Virginia Beach, VA 23452-1783 | 2020-10-28 |
| 1881208650 | Tracie Marie Romero | Counselor | 236 Mustag Trail Ste, Virginia Beach, VA 23452 | 2020-08-31 |
| 1912510991 | Briahna Van Nostern | Counselor | 669 Pinebrook Dr, Virginia Beach, VA 23462-4772 | 2020-08-28 |
| 1750999280 | Barbara Stuart Ford | Counselor | 6477 College Park Sq Ste 216, Virginia Beach, VA 23464-3611 | 2020-07-21 |
| 1184242489 | Leah Laura Crawford | Counselor | 2397 Liberty Way Ste 103, Virginia Beach, VA 23456-3464 | 2020-07-13 |
| 1871119321 | Pembroke Psychotherapy LLC | Counselor | 4605 Pembroke Lake Cir Ste 103c, Virginia Beach, VA 23455-6434 | 2020-06-21 |
| 1285256768 | Robyn Melinda Leroy | Counselor | 1064 Laskin Rd Ste 14c, Virginia Beach, VA 23451-6337 | 2020-05-07 |
| 1013543560 | Frank Douglass Bond | Counselor | 5267 Greenwich Rd Ste 100, Virginia Beach, VA 23462-6028 | 2020-03-17 |
| 1821621640 | Hailey Rae Gier | Counselor | 4420 Bear Trl, Virginia Beach, VA 23456-7308 | 2020-02-20 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23462 |
Please comment or provide details below to improve the information on MR. JERRY EDWARD PARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.