Provider Demographics
NPI:1164968053
Name:HAPP, LAURA A (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:HAPP
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 1:10810 STUTELY DR
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-9598
Mailing Address - Country:US
Mailing Address - Phone:574-485-1807
Mailing Address - Fax:
Practice Address - Street 1:300 S SAINT LOUIS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-3043
Practice Address - Country:US
Practice Address - Phone:574-232-2131
Practice Address - Fax:574-271-5980
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003098A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN34003098AOtherSTATE LICENSE