Provider Demographics
NPI:1275952574
Name:CALDARERA, LAURA ANN (LPC, LCAS)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:CALDARERA
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 WOODSON DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-3916
Mailing Address - Country:US
Mailing Address - Phone:919-523-1197
Mailing Address - Fax:
Practice Address - Street 1:1420A S POLLOCK ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:NC
Practice Address - Zip Code:27576-3404
Practice Address - Country:US
Practice Address - Phone:919-351-0428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2435101YA0400X
NC8273101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)