Provider Demographics
NPI:1790103935
Name:WINGFIELD, NATALIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:
Last Name:WINGFIELD
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 1:1561 BRADFORD RD
Mailing Address - Street 2:STE 102
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-4081
Mailing Address - Country:US
Mailing Address - Phone:757-409-7172
Mailing Address - Fax:
Practice Address - Street 1:1561 BRADFORD RD
Practice Address - Street 2:STE 102
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-4081
Practice Address - Country:US
Practice Address - Phone:757-409-7172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005771101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional