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Individual

PHYLLIS MARIE MCLAURIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1435 CROSSWAYS BLVD, SUITE 109, CHESAPEAKE, VA 23320-2896
(757) 410-0072
(757) 410-7290
Mailing address
1435 CROSSWAYS BLVD, SUITE 109, CHESAPEAKE, VA 23320-2896
(757) 410-0072
(757) 410-7290

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710101598
VA
1041C0700X
Clinical Social Worker
0904007833
VA

Other

Enumeration date
08/06/2012
Last updated
08/06/2012
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