Provider Demographics
NPI:1811529886
Name:LOYD, GARY (LPC, LSATP)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:LOYD
Suffix:
Gender:M
Credentials:LPC, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 LITTLETOWN QUARTER
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5555
Mailing Address - Country:US
Mailing Address - Phone:757-206-3001
Mailing Address - Fax:
Practice Address - Street 1:213 N BOUNDARY ST STE 203
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3666
Practice Address - Country:US
Practice Address - Phone:757-206-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000296101YA0400X
VA0701005942101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)