Provider Demographics
NPI:1093919128
Name:CARWELL, LAURA ANN (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:CARWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:CARWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:3960 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-8944
Mailing Address - Country:US
Mailing Address - Phone:918-519-9337
Mailing Address - Fax:
Practice Address - Street 1:7633 E 63RD PL STE 300
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1202
Practice Address - Country:US
Practice Address - Phone:918-519-9337
Practice Address - Fax:918-747-7668
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3414101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor