Provider Demographics
NPI:1376970756
Name:GRASS, LAURA ELLEN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ELLEN
Last Name:GRASS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 N JOSEY LN
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5543
Mailing Address - Country:US
Mailing Address - Phone:972-466-2800
Mailing Address - Fax:
Practice Address - Street 1:2625 N JOSEY LN
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5543
Practice Address - Country:US
Practice Address - Phone:972-466-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71010101YP2500X
NC7513101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional