Provider Demographics
NPI:1588913511
Name:LAURA RAGINS
Entity type:Organization
Organization Name:LAURA RAGINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGINS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:703-228-1592
Mailing Address - Street 1:2100 WASHINGTON BLVD
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-5703
Mailing Address - Country:US
Mailing Address - Phone:703-228-1592
Mailing Address - Fax:
Practice Address - Street 1:2100 WASHINGTON BLVD
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5703
Practice Address - Country:US
Practice Address - Phone:703-228-1592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000309251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health