Provider Demographics
NPI:1043861693
Name:LAUGHLIN, MARQUITA P (MA, MSW, LCSW-A)
Entity Type:Individual
Prefix:
First Name:MARQUITA
Middle Name:P
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:MA, MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7745 FORDING BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-6343
Mailing Address - Country:US
Mailing Address - Phone:910-308-2095
Mailing Address - Fax:
Practice Address - Street 1:7745 FORDING BRIDGE RD
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-6343
Practice Address - Country:US
Practice Address - Phone:910-308-2095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0135381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical