Provider Demographics
NPI:1396322665
Name:LAURA BRIGHTON, LCSW
Entity type:Organization
Organization Name:LAURA BRIGHTON, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-907-2567
Mailing Address - Street 1:913 FIRST COLONIAL RD STE 204
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3198
Mailing Address - Country:US
Mailing Address - Phone:757-622-7017
Mailing Address - Fax:757-640-8402
Practice Address - Street 1:913 FIRST COLONIAL RD STE 204
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3198
Practice Address - Country:US
Practice Address - Phone:757-622-7017
Practice Address - Fax:757-640-8402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904002453OtherLICENSE