Provider Demographics
NPI:1477870145
Name:LAIRD, TERESA G (LPC, NBCC)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:G
Last Name:LAIRD
Suffix:
Gender:F
Credentials:LPC, NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 CENTER ST
Mailing Address - Street 2:535
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536-5072
Mailing Address - Country:US
Mailing Address - Phone:713-515-0502
Mailing Address - Fax:
Practice Address - Street 1:3801 CENTER ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-5072
Practice Address - Country:US
Practice Address - Phone:713-515-0502
Practice Address - Fax:281-884-8352
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3098101YP2500X
TX19510101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional