Provider Demographics
NPI:1457664294
Name:CARTWRIGHT, LAURA ELAINE (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ELAINE
Last Name:CARTWRIGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-5406
Mailing Address - Country:US
Mailing Address - Phone:208-930-1275
Mailing Address - Fax:208-625-2070
Practice Address - Street 1:212 S 11TH ST STE 3
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4000
Practice Address - Country:US
Practice Address - Phone:208-930-1275
Practice Address - Fax:208-930-0330
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW 308221041C0700X
IDLMSW-267351041C0700X
308221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2071711Medicaid