Provider Demographics
NPI:1437665403
Name:COE, LAURA (LMHC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:COE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LORELEI
Other - Middle Name:
Other - Last Name:COE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1156 S CARPENTER AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1156 S CARPENTER AVE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7009
Practice Address - Country:US
Practice Address - Phone:386-222-2935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16925101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health