Provider Demographics
NPI:1669943817
Name:LANAVILLE, DAWN Y (PHD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:Y
Last Name:LANAVILLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 CHAPARRAL DR
Mailing Address - Street 2:BLDG B, STE 201
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4369
Mailing Address - Country:US
Mailing Address - Phone:540-750-0066
Mailing Address - Fax:
Practice Address - Street 1:3130 CHAPARRAL DR STE 201
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4369
Practice Address - Country:US
Practice Address - Phone:540-750-0066
Practice Address - Fax:252-562-6013
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810006342103TF0200X, 103TC0700X
NC5473103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA11543721OtherSCCID
NC1770181OtherSOSID