Provider Demographics
NPI:1235794561
Name:GALE, LAURA OLNEY (LICSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:OLNEY
Last Name:GALE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N CONCEPTION ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36603-6477
Mailing Address - Country:US
Mailing Address - Phone:251-320-5875
Mailing Address - Fax:251-459-0065
Practice Address - Street 1:205 N CONCEPTION ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36603-6477
Practice Address - Country:US
Practice Address - Phone:251-320-5875
Practice Address - Fax:251-315-0012
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-02
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4159C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical