Provider Demographics
NPI:1417329525
Name:BRENNAN, LAURA ASHLEY (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ASHLEY
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 KINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-2208
Mailing Address - Country:US
Mailing Address - Phone:617-338-9000
Mailing Address - Fax:617-482-6623
Practice Address - Street 1:5110 VELASKO RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-1983
Practice Address - Country:US
Practice Address - Phone:315-567-1137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health