Provider Demographics
NPI:1063173599
Name:BENDER, NADIA LASZIG (LCSW)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:LASZIG
Last Name:BENDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 ESTATE DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6008
Mailing Address - Country:US
Mailing Address - Phone:170-361-8678
Mailing Address - Fax:
Practice Address - Street 1:610 THIMBLE SHOALS BLVD STE 403
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2573
Practice Address - Country:US
Practice Address - Phone:757-534-7840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040135631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical