Provider Demographics
NPI:1336670314
Name:MEADOW, LAURA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:MEADOW
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 1:80 WOLFE LN
Mailing Address - Street 2:
Mailing Address - City:ERIN
Mailing Address - State:TN
Mailing Address - Zip Code:37061-5122
Mailing Address - Country:US
Mailing Address - Phone:615-438-3615
Mailing Address - Fax:931-906-9735
Practice Address - Street 1:120 CENTER POINTE DR
Practice Address - Street 2:STE. 1
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-1632
Practice Address - Country:US
Practice Address - Phone:615-438-3615
Practice Address - Fax:931-906-9735
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1080106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist