Provider Demographics
NPI:1003104506
Name:PASCH, LAURA L (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:PASCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37832 PERKINS CT
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-3118
Mailing Address - Country:US
Mailing Address - Phone:703-728-8229
Mailing Address - Fax:
Practice Address - Street 1:37832 PERKINS CT
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3118
Practice Address - Country:US
Practice Address - Phone:703-728-8229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040054341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical