Provider Demographics
NPI:1073975280
Name:LAURA'S THERAPEUTIC SOLUTIONS LLC
Entity Type:Organization
Organization Name:LAURA'S THERAPEUTIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name::LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-690-3154
Mailing Address - Street 1:758 CHAMBERLAIN PL
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-2716
Mailing Address - Country:US
Mailing Address - Phone:314-690-3154
Mailing Address - Fax:
Practice Address - Street 1:758 CHAMBERLAIN PL
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-2716
Practice Address - Country:US
Practice Address - Phone:314-690-3154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-26
Last Update Date:2016-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015033641251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health