Provider Demographics
NPI:1083912596
Name:WELSH, LAURA (LPC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:WELSH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3958
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1489 BALTIMORE PIKE STE 200
Practice Address - Street 2:SUITE 250
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3958
Practice Address - Country:US
Practice Address - Phone:610-544-2110
Practice Address - Fax:610-544-2110
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005773101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional