Provider Information for 1861749129
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
PHYLLIS MARIE MCLAURIN LCSW
Sex: Female
NPI: 1861749129
Last Updated: 2012-08-06
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1861749129 | ||||||||||||
| Enumeration Date | 2012-08-06 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1435 CROSSWAYS BLVD SUITE 109 CHESAPEAKE, VA 23320-2896 United States Phone: 757-410-0072 | Fax:757-410-7290 | ||||||||||||
| Primary Practice Address | 1435 CROSSWAYS BLVD SUITE 109 CHESAPEAKE, VA 23320-2896 United States Phone: 757-410-0072 | Fax:757-410-7290 | ||||||||||||
| Secondary Practice Address(es) | |||||||||||||
| Health Information Exchange |
| ||||||||||||
| Other Identifiers |
| ||||||||||||
| Taxonomy |
|