Provider Demographics
NPI:1407945363
Name:LEGAL, FORENSIC AND TRAINING CONSULTANTS OF VA, PC
Entity Type:Organization
Organization Name:LEGAL, FORENSIC AND TRAINING CONSULTANTS OF VA, PC
Other - Org Name:LFTC OF VA, PC-THERAPEUTIC OPTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:DEVIN
Authorized Official - Last Name:BEVERLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, LSATP
Authorized Official - Phone:757-262-1461
Mailing Address - Street 1:PO BOX 5122
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23605-0122
Mailing Address - Country:US
Mailing Address - Phone:757-262-1461
Mailing Address - Fax:
Practice Address - Street 1:2019 CUNNINGHAM DR
Practice Address - Street 2:SUITE 218
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3316
Practice Address - Country:US
Practice Address - Phone:757-262-1461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000158101YA0400X
VA0701003321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA336367OtherMHN