Provider Demographics
NPI:1992734230
Name:HASKELL, ALBERT LEONARD (LPC)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:LEONARD
Last Name:HASKELL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11018 SAVOY RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-3546
Mailing Address - Country:US
Mailing Address - Phone:804-330-0770
Mailing Address - Fax:
Practice Address - Street 1:10109 KRAUSE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6501
Practice Address - Country:US
Practice Address - Phone:804-751-8644
Practice Address - Fax:804-751-0648
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003592101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAO85841MOtherSENTARA/SOUTHERN HEALTH
VA147511OtherANTHEM HEALTHKEEPERS/PLUS