Healthcare Provider Details

I. General information

NPI: 1407945363
Provider Name (Legal Business Name): LEGAL, FORENSIC AND TRAINING CONSULTANTS OF VA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 CUNNINGHAM DR SUITE 218
HAMPTON VA
23666-3316
US

IV. Provider business mailing address

PO BOX 5122
NEWPORT NEWS VA
23605-0122
US

V. Phone/Fax

Practice location:
  • Phone: 757-262-1461
  • Fax:
Mailing address:
  • Phone: 757-262-1461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0718000158
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701003321
License Number StateVA

VIII. Authorized Official

Name: DR. RONALD DEVIN BEVERLY
Title or Position: PRESIDENT
Credential: PH.D., LPC, LSATP
Phone: 757-262-1461