Provider Demographics
NPI:1043527120
Name:HOLLAND, LAURA LYNN (LPC-S)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LYNN
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LYNN
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC-S
Mailing Address - Street 1:1513 LINE AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4621
Mailing Address - Country:US
Mailing Address - Phone:318-617-5333
Mailing Address - Fax:
Practice Address - Street 1:1513 LINE AVE STE 250
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4621
Practice Address - Country:US
Practice Address - Phone:318-617-5333
Practice Address - Fax:318-742-6599
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA752101YP2500X
LA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional