Provider Demographics
NPI:1235160813
Name:LAMIELLE, ROBERT (LCP)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:LAMIELLE
Suffix:
Gender:M
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 EXECUTIVE DR (PRIMARY)
Mailing Address - Street 2:SUITE C
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6604
Mailing Address - Country:US
Mailing Address - Phone:757-827-7707
Mailing Address - Fax:757-838-2573
Practice Address - Street 1:6330 NEWTOWN RD
Practice Address - Street 2:SUITE 300
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4802
Practice Address - Country:US
Practice Address - Phone:757-466-3336
Practice Address - Fax:757-455-5750
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA810002546103T00000X
VA0810002546103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010829G34OtherMEDICARE
VA20-4459309OtherCHOICE CARE
VA459414000OtherMAGELLAN
VA20-4459309OtherGREAT WEST
VA20-4459309OtherUNITED BH
VA236803OtherANTHEM BC/BC
VA328201OtherTRICARE
VA7714734OtherMENTAL HN
VA7714734Medicaid
VA214929OtherCOM PSYCH
VA244656OtherVALUE OPTIONS
VA20-4459309OtherAMERICAN PSYCH SYS
VA20-4459309OtherSENTARA
VA20-4459309OtherVIRGINIA HN
VA20-4459309OtherBHS
VA20-4459309OtherPRIVATE HCS
VA7714734Medicaid