Provider Demographics
NPI:1275136582
Name:LAIDLOW, BEVERLY (LMHP-R)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:LAIDLOW
Suffix:
Gender:F
Credentials:LMHP-R
Other - Prefix:MRS
Other - First Name:BEVERLY
Other - Middle Name:
Other - Last Name:LAIDLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WALKER
Mailing Address - Street 1:1022 HOLLYMEADE CIR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-2013
Mailing Address - Country:US
Mailing Address - Phone:856-359-5188
Mailing Address - Fax:
Practice Address - Street 1:2147 OLD GREENBRIER RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2635
Practice Address - Country:US
Practice Address - Phone:757-970-0353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704009795101YM0800X
VA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)