Provider Demographics
NPI:1801080585
Name:VIRGA, JENNIFER L (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:VIRGA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12320 HIGHWAY 44
Mailing Address - Street 2:STE 3D
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-2202
Mailing Address - Country:US
Mailing Address - Phone:225-933-4232
Mailing Address - Fax:225-933-4232
Practice Address - Street 1:12320 HIGHWAY 44
Practice Address - Street 2:STE 3D
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-2202
Practice Address - Country:US
Practice Address - Phone:225-933-4232
Practice Address - Fax:225-933-4232
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical