Provider Demographics
NPI:1083818199
Name:LAWTON, THEA GARNES (LPC)
Entity Type:Individual
Prefix:
First Name:THEA
Middle Name:GARNES
Last Name:LAWTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 CROSSWAYS BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3360
Mailing Address - Country:US
Mailing Address - Phone:757-523-8026
Mailing Address - Fax:
Practice Address - Street 1:1434 CROSSWAYS BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3360
Practice Address - Country:US
Practice Address - Phone:757-523-8026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1659424448Medicaid