Provider Demographics
NPI:1902390321
Name:CHITWOOD, LAURA PETERS (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:PETERS
Last Name:CHITWOOD
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 1:3012 PIEDMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23834-5717
Mailing Address - Country:US
Mailing Address - Phone:804-840-8457
Mailing Address - Fax:804-893-3721
Practice Address - Street 1:10128 HULL STREET RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112
Practice Address - Country:US
Practice Address - Phone:804-744-1114
Practice Address - Fax:804-893-3721
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701007696OtherDEPARTMENT OF HEALTH PROFESSIONALS