Provider Demographics
NPI:1821317850
Name:CLEMENT, LAURA G (LCSW, LCSW-C, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:G
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:LCSW, LCSW-C, LICSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:E
Other - Last Name:GILMOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW
Mailing Address - Street 1:4740 CONNECTICUT AVE NW
Mailing Address - Street 2:APT. 504
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5628
Mailing Address - Country:US
Mailing Address - Phone:757-876-0643
Mailing Address - Fax:
Practice Address - Street 1:1495 CHAIN BRIDGE RD
Practice Address - Street 2:WEAVER AND ASSOCIATES, PLLC, STE 300
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5727
Practice Address - Country:US
Practice Address - Phone:202-577-6836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040077111041C0700X
MD171801041C0700X
DCLC500791081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical