Laurie Shea

Primary specialty

CounselorTaxonomy code 101Y00000X

License

07010013044 Issued in VA

Legal business name

LAURIE SHEA

Practice address

120 Ponderosa Dr
Suite D
Christiansburg, VA 24073-6598

Phone

(540) 382-1494

Fax

(540) 344-7154

NPI assigned

Apr 29, 2008

Last updated

Jun 21, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Laurie Shea, PHD

Title

Owner

Phone

(540) 382-1494

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1871768838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4127",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240150127",
            "telephone_number": "540-981-9394",
            "fax_number": "540-311-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PONDEROSA DR",
            "address_2": "SUITE D",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240736598",
            "telephone_number": "540-382-1494",
            "fax_number": "540-344-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURIE SHEA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-382-1494",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "07010013044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821036153",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Christiansburg, VA
• Providers in Christiansburg, VA by specialty
• Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.