Provider Demographics
NPI:1174816896
Name:MCLAURIN, LAKESHA NICOLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LAKESHA
Middle Name:NICOLE
Last Name:MCLAURIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:LAKESHA
Other - Middle Name:NICOLE
Other - Last Name:MATTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:156 S MAIN ST
Mailing Address - Street 2:STE. 130
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-7881
Mailing Address - Country:US
Mailing Address - Phone:409-200-2220
Mailing Address - Fax:409-440-3344
Practice Address - Street 1:156 S MAIN ST
Practice Address - Street 2:STE. 130
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-7881
Practice Address - Country:US
Practice Address - Phone:409-200-2220
Practice Address - Fax:409-440-3344
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health