Provider Demographics
NPI:1316581408
Name:WESSON, LAURA O (LCMHC, LCAS, NCC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:O
Last Name:WESSON
Suffix:
Gender:F
Credentials:LCMHC, LCAS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205K OAK RIDGE RD UNIT 170
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27310-9619
Mailing Address - Country:US
Mailing Address - Phone:704-966-9517
Mailing Address - Fax:
Practice Address - Street 1:6723 BASTILLE LN
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:NC
Practice Address - Zip Code:27310-9740
Practice Address - Country:US
Practice Address - Phone:704-966-9517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-24358101YA0400X
NCA14510101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)