Provider Demographics
NPI:1962731059
Name:EASTER, LAURA T (LPC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:T
Last Name:EASTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 MIDDLE FARMS TRCE
Mailing Address - Street 2:
Mailing Address - City:BREMO BLUFF
Mailing Address - State:VA
Mailing Address - Zip Code:23022-2143
Mailing Address - Country:US
Mailing Address - Phone:540-586-4023
Mailing Address - Fax:540-586-0747
Practice Address - Street 1:94 MIDDLE FARMS TRCE
Practice Address - Street 2:
Practice Address - City:BREMO BLUFF
Practice Address - State:VA
Practice Address - Zip Code:23022-2143
Practice Address - Country:US
Practice Address - Phone:540-586-4023
Practice Address - Fax:540-586-0747
Is Sole Proprietor?:No
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004233101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional