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General NPI Number Information
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NPI Number | 1821317850
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Entity Type | Individual
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Provider Name | LAURA G. CLEMENT LCSW, LCSW-C, LICSW
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Gender | Female
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Dates
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Enumeration Date | 06/01/2010
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 1495 CHAIN BRIDGE RD WEAVER AND ASSOCIATES, PLLC, STE 300
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City | MC LEAN
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State | VA
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Zip | 22101-5727
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Country | US
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Telephone | 202-577-6836
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Fax |
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Provider Business Mailing Address
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Address Line | 4740 CONNECTICUT AVE NW APT. 504
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City | WASHINGTON
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State | DC
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Zip | 20008-5628
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Country | US
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Telephone | 757-876-0643
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904007711
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 17180
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50079108
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License Number State | DC
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