Provider Demographics
NPI:1033913181
Name:LORD, MATTHEW R (LPC-R)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:LORD
Suffix:
Gender:
Credentials:LPC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CHANCO RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2404
Mailing Address - Country:US
Mailing Address - Phone:757-784-4731
Mailing Address - Fax:
Practice Address - Street 1:3404 ACORN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-1095
Practice Address - Country:US
Practice Address - Phone:757-784-4731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704005201101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional