Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jerly Henriquez, LPCR

Individual provider Counselor · NPI 1063225225

Jerly Henriquez, LPCR is a Mental Health Counselor in Fairfax, Virginia. Qualified in 2023, 3 years ago. Licensed in Virginia.

Years since qualifying
3
Licensed in
VA
In the registry since
2025
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Practice location Address checks out

10721 Main St Ste 2400
Fairfax, VA 22030-6902
Phone: (703) 270-0225
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence 0704016745 (VA)

Record details

NPI number1063225225
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPCR
Sole proprietorNo
NPI enumeratedJanuary 30, 2025
Last updated in NPPESJanuary 30, 2025
Certification dateJanuary 30, 2025
Mailing address10721 Main St Ste 2400, Fairfax, VA 22030-6902

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Fairfax