1699748673 NPI number — MS. LAUREL N LLOBELL LPC

Table of content: MS. LAUREL N LLOBELL LPC (NPI 1699748673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699748673 NPI number — MS. LAUREL N LLOBELL LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LLOBELL
Provider First Name:
LAUREL
Provider Middle Name:
N
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699748673
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
770 LYNNHAVEN PARKWAY
Provider Second Line Business Mailing Address:
SUITE 240
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-962-2780
Provider Business Mailing Address Fax Number:
757-240-5936

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
770 LYNNHAVEN PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-962-2780
Provider Business Practice Location Address Fax Number:
757-240-5936
Provider Enumeration Date:
02/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  0701003232 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101Y00000X , with the licence number: 0701003232 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 089390 . This is a "SENTARA OPTIMA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 005413664 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2122755 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 327268 . This is a "MANAGED HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 436344 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 436344 . This is a "ANTHEM PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 470669 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 202397 . This is a "COM PSYCH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4636344 . This is a "ANTHEM HEALTH KEEPERS" identifier . This identifiers is of the category "OTHER".




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