Provider Demographics
NPI:1770022709
Name:WARDEN, LAURA HARTY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:HARTY
Last Name:WARDEN
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 1:1485 CHAIN BRIDGE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4501
Mailing Address - Country:US
Mailing Address - Phone:703-989-2806
Mailing Address - Fax:
Practice Address - Street 1:1485 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4501
Practice Address - Country:US
Practice Address - Phone:703-989-2806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040089611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical