Provider Demographics
NPI:1033662903
Name:LAPRADE, SAMUEL
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:LAPRADE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8022 TIMBERLAKE RD
Mailing Address - Street 2:UNIT 43
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2643
Mailing Address - Country:US
Mailing Address - Phone:434-610-9323
Mailing Address - Fax:
Practice Address - Street 1:8022 TIMBERLAKE RD
Practice Address - Street 2:UNIT 43
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2643
Practice Address - Country:US
Practice Address - Phone:434-610-9323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor