Provider Demographics
NPI:1548538986
Name:DEL CORSO, JENNIFER JORDAN (LPC, PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JORDAN
Last Name:DEL CORSO
Suffix:
Gender:F
Credentials:LPC, PHD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:707 GUM ROCK COURT
Mailing Address - Street 2:PENINSULA PASTORAL COUNSELING CENTER
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-873-2273
Mailing Address - Fax:757-873-9422
Practice Address - Street 1:707 GUM ROCK COURT
Practice Address - Street 2:PENINSULA PASTORAL COUNSELING CENTER
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-873-2273
Practice Address - Fax:757-873-9422
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005073101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor