Provider Demographics
NPI:1346428216
Name:LAWYER, LAURA DANIEL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:DANIEL
Last Name:LAWYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:JILL
Other - Last Name:DANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2504 RAEFORD RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5294
Mailing Address - Country:US
Mailing Address - Phone:910-423-9900
Mailing Address - Fax:910-423-0537
Practice Address - Street 1:2504 RAEFORD RD
Practice Address - Street 2:SUITE 108
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5294
Practice Address - Country:US
Practice Address - Phone:910-423-9900
Practice Address - Fax:910-423-0537
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-03
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0044831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106996Medicaid