Provider Demographics
NPI:1265664882
Name:HENNESS, LAURA LEA (LMFT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEA
Last Name:HENNESS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 BROWN CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:OSAWATOMIE
Mailing Address - State:KS
Mailing Address - Zip Code:66064-1636
Mailing Address - Country:US
Mailing Address - Phone:913-731-2751
Mailing Address - Fax:
Practice Address - Street 1:518 BROWN CIRCLE DR
Practice Address - Street 2:
Practice Address - City:OSAWATOMIE
Practice Address - State:KS
Practice Address - Zip Code:66064-1636
Practice Address - Country:US
Practice Address - Phone:913-731-2751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-15
Last Update Date:2009-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS759106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist