Healthcare Provider Details

I. General information

NPI: 1295666428
Provider Name (Legal Business Name): LAUREN CHASE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 DILIGENCE DR STE 102
NEWPORT NEWS VA
23606-4211
US

IV. Provider business mailing address

151 LANDS END LN APT C
NEWPORT NEWS VA
23608-8438
US

V. Phone/Fax

Practice location:
  • Phone: 254-249-6530
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: