Provider Demographics
NPI:1083953004
Name:MOUNT, LAURA T (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:T
Last Name:MOUNT
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 1:120 WESTLAKE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-4451
Mailing Address - Country:US
Mailing Address - Phone:910-273-9333
Mailing Address - Fax:910-867-4600
Practice Address - Street 1:120 WESTLAKE RD
Practice Address - Street 2:STE. 1
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-4451
Practice Address - Country:US
Practice Address - Phone:910-867-9754
Practice Address - Fax:910-867-4600
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0092911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical