Healthcare Provider Details

I. General information

NPI: 1699748673
Provider Name (Legal Business Name): LAUREL N LLOBELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 06/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 LYNNHAVEN PARKWAY SUITE 240
VIRGINIA BEACH VA
23452
US

IV. Provider business mailing address

770 LYNNHAVEN PARKWAY SUITE 240
VIRGINIA BEACH VA
23452
US

V. Phone/Fax

Practice location:
  • Phone: 757-962-2780
  • Fax: 757-240-5936
Mailing address:
  • Phone: 757-962-2780
  • Fax: 757-240-5936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701003232
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0701003232
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: