Healthcare Provider Details

I. General information

NPI: 1538150040
Provider Name (Legal Business Name): HELEN M LATHROP PSY. D
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 LIBBIE AVE SUITE 206
RICHMOND VA
23226-1837
US

IV. Provider business mailing address

7149 JAHNKE RD
RICHMOND VA
23225-4017
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-8377
  • Fax: 804-320-2050
Mailing address:
  • Phone: 804-320-7881
  • Fax: 804-320-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810001976
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: