Provider Demographics
NPI:1417016239
Name:BUCK, LAURA MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MARIE
Last Name:BUCK
Suffix:
Gender:F
Credentials:LCSW
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Other - Credentials:
Mailing Address - Street 1:LOUIS STOKES CLEVELAND MEDICAL CENTER
Mailing Address - Street 2:1406 TOD AVE NW WARREN VA CBOC
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485
Mailing Address - Country:US
Mailing Address - Phone:330-392-0311
Mailing Address - Fax:216-229-2897
Practice Address - Street 1:LOUIS STOKES CLEVELAND MEDICAL CENTER
Practice Address - Street 2:1406 TOD AVE NW WARREN VA CBOC
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485
Practice Address - Country:US
Practice Address - Phone:330-392-0311
Practice Address - Fax:216-229-2897
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA6629101YA0400X
PACW0150571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)