Provider Demographics
NPI:1215258769
Name:SAMALYA, LAURA MICHELLE (MA)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MICHELLE
Last Name:SAMALYA
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:DANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2613 ELON DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4355
Mailing Address - Country:US
Mailing Address - Phone:757-406-1716
Mailing Address - Fax:
Practice Address - Street 1:5250 CHALLEDON DR STE 200
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6304
Practice Address - Country:US
Practice Address - Phone:757-406-1716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007933101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional