Provider Demographics
NPI:1275140600
Name:LLOYD, KATHLEEN MATTU (MS, LPC, CSAC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MATTU
Last Name:LLOYD
Suffix:
Gender:F
Credentials:MS, LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 COLOGNE CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5838
Mailing Address - Country:US
Mailing Address - Phone:808-225-5883
Mailing Address - Fax:
Practice Address - Street 1:1700 PLEASURE HOUSE RD STE 102A
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-4062
Practice Address - Country:US
Practice Address - Phone:757-578-2985
Practice Address - Fax:757-578-5064
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009942101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional