Provider Demographics
NPI:1467138321
Name:CHAPEAU, LAURA (LISW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CHAPEAU
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:WALKER
Other - Last Name:STUTELBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 W 107TH ST.
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420
Mailing Address - Country:US
Mailing Address - Phone:651-245-7267
Mailing Address - Fax:
Practice Address - Street 1:210 W 107TH ST.
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420
Practice Address - Country:US
Practice Address - Phone:651-245-7267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20460104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker