Provider Demographics
NPI:1467780833
Name:ADAY, LAURA STRACK (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:STRACK
Last Name:ADAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:STRACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:9101 KANIS RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6456
Mailing Address - Country:US
Mailing Address - Phone:501-320-3216
Mailing Address - Fax:501-320-3296
Practice Address - Street 1:9101 KANIS RD
Practice Address - Street 2:STE. 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6456
Practice Address - Country:US
Practice Address - Phone:501-320-3216
Practice Address - Fax:501-320-3296
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2474-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5V571Medicare PIN