Doctor Name: | KENNETH L LABASKY |
NPI Number: | 1003803453 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 0904000814 |
Business Practice Address: | 3300 Academy Ave Portsmouth, VA - 237033205 |
Business Phone Number: | 7574836404 |
Business Fax Number: | 7574830737 |
Mailing Address: | 3300 Academy Ave, PORTSMOUTH |
State: | VA |
Postal Code: | 237033205 |
Phone Number: | 7574836404 |
Fax Number: | 7574830737 |
NPI Enumeration Date: | 09/30/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0904000814 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |