Provider Demographics
NPI:1376610626
Name:MCDONALD, LAURA E (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-3825
Mailing Address - Country:US
Mailing Address - Phone:804-819-4024
Mailing Address - Fax:804-819-5221
Practice Address - Street 1:107 S 5TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-3825
Practice Address - Country:US
Practice Address - Phone:804-819-4024
Practice Address - Fax:804-819-5221
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904005879101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health