Organization
LOOSELEAF CLINICAL CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LETITIA LAURIEN LCSW (CEO)
(757) 503-4471
Entity
Organization
Contact information
Practice address
685 TURNBERRY BLVD, #14774, NEWPORT NEWS, VA 23608-0290
(757) 240-9497
Mailing address
685 TURNBERRY BLVD, #14774, NEWPORT NEWS, VA 23608-0290
(757) 240-9497
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0904007077
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013158963
NPI
—
05
—
5573
—
VA
Enumeration date
11/04/2016
Last updated
11/04/2016
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