MR. Jerry Edward Park, LPC

NPI #1457381360 in Hampton, Virginia

Provider Information

NPI Number: 1457381360
Entity Type: Individual
Name: MR. Jerry Edward Park, LPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: Jul 4, 2006
Last Updated: Mar 20, 2025

Practice Location

Address: 2202 EXECUTIVE DR STE C
City: Hampton
State: Virginia
ZIP Code: 23666-6604
Phone: (757) 827-7707

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X	Primary

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