Provider Demographics
NPI:1528338274
Name:FARMER, LAURA BOYD (PHD, LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:BOYD
Last Name:FARMER
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3959 ELECTRIC RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4562
Mailing Address - Country:US
Mailing Address - Phone:540-266-7418
Mailing Address - Fax:540-266-7632
Practice Address - Street 1:3959 ELECTRIC RD
Practice Address - Street 2:SUITE 160
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4562
Practice Address - Country:US
Practice Address - Phone:540-266-7418
Practice Address - Fax:540-266-7632
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004797101Y00000X
VA0710102339101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)