Provider Demographics
NPI:1417837972
Name:TANN, AJAH VONE' (MA, LPC)
Entity type:Individual
Prefix:
First Name:AJAH
Middle Name:VONE'
Last Name:TANN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3724 PHEASANT RUN DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-7059
Mailing Address - Country:US
Mailing Address - Phone:252-281-8556
Mailing Address - Fax:
Practice Address - Street 1:3724 PHEASANT RUN DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-7059
Practice Address - Country:US
Practice Address - Phone:252-281-8556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704018027101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty