Provider Demographics
NPI:1174510903
Name:TOWNSEND, LAURA LEE
Entity type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:LEE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23187-0279
Mailing Address - Country:US
Mailing Address - Phone:757-253-0111
Mailing Address - Fax:757-253-2884
Practice Address - Street 1:247 MCLAWS CIR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5649
Practice Address - Country:US
Practice Address - Phone:757-253-0111
Practice Address - Fax:757-253-2884
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000043101YA0400X
VA0701000681101YP2500X
VA0717000161106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist