Provider Demographics
NPI:1427182815
Name:LAFAYETTE PSYCHIATRIC SERVICES
Entity Type:Organization
Organization Name:LAFAYETTE PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HYDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-627-3898
Mailing Address - Street 1:1443 N VEAUX LOOP
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23509-1259
Mailing Address - Country:US
Mailing Address - Phone:757-627-3898
Mailing Address - Fax:757-627-0054
Practice Address - Street 1:1443 N VEAUX LOOP
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23509-1259
Practice Address - Country:US
Practice Address - Phone:757-627-3898
Practice Address - Fax:757-627-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238635101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty