Healthcare Provider Details

I. General information

NPI: 1295194595
Provider Name (Legal Business Name): NATALIE CLAVON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 BYRD AVE STE 200
RICHMOND VA
23230-3033
US

IV. Provider business mailing address

1900 BYRD AVE STE 200
RICHMOND VA
23230-3033
US

V. Phone/Fax

Practice location:
  • Phone: 804-592-6311
  • Fax: 804-237-0532
Mailing address:
  • Phone: 804-592-6311
  • Fax: 804-237-0532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701006489
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: