Provider Demographics
NPI:1467047845
Name:RENSHAW, DARLA SHAY (LPC)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:SHAY
Last Name:RENSHAW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5964 DERWENT RD
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-4620
Mailing Address - Country:US
Mailing Address - Phone:928-273-7930
Mailing Address - Fax:
Practice Address - Street 1:5964 DERWENT RD
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-4620
Practice Address - Country:US
Practice Address - Phone:928-273-7930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-07
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health