Provider Demographics
NPI:1043383318
Name:SAWYER, LARRY BERNARD (LPC, SOTP)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:BERNARD
Last Name:SAWYER
Suffix:
Gender:M
Credentials:LPC, SOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 GREAT BRIDGE BLVD.
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320
Mailing Address - Country:US
Mailing Address - Phone:757-547-9334
Mailing Address - Fax:757-819-6292
Practice Address - Street 1:224 GREAT BRIDGE BLVD.
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-547-9334
Practice Address - Fax:757-819-6292
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002303101YM0800X
VA0812000321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA548640000OtherMAGELLAN HEALTH
VA324337OtherANTHEM TRIGON
VA242503OtherMASMI/UNITED BEH HEALTH
VA085330OtherVALUE OPTIONS
VA085753OtherOPTMA SFC