Provider Demographics
NPI:1801379698
Name:HAMLETTE, LAURA (MS, LPC, CSAC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HAMLETTE
Suffix:
Gender:F
Credentials:MS, LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 ROBERTS TRL
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:VA
Mailing Address - Zip Code:24558-3042
Mailing Address - Country:US
Mailing Address - Phone:434-579-7140
Mailing Address - Fax:
Practice Address - Street 1:424 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-5200
Practice Address - Country:US
Practice Address - Phone:434-572-2936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-08
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007846101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional