Provider Demographics
NPI:1134666704
Name:TAGUE, NATALIA (LPC)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:TAGUE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NATALIA
Other - Middle Name:
Other - Last Name:BOYARINOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:819 MONTEBELLO CIR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-7245
Mailing Address - Country:US
Mailing Address - Phone:757-232-5296
Mailing Address - Fax:
Practice Address - Street 1:819 MONTEBELLO CIR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-7245
Practice Address - Country:US
Practice Address - Phone:757-232-5296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006930101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional