Provider Demographics
NPI:1477944619
Name:LAUDICK, SHARON R (LCMFT, LCAC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:R
Last Name:LAUDICK
Suffix:
Gender:F
Credentials:LCMFT, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 SW HUNTBROOK TER
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-1547
Mailing Address - Country:US
Mailing Address - Phone:316-258-2417
Mailing Address - Fax:
Practice Address - Street 1:2005 SW HUNTBROOK TER
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64082-1547
Practice Address - Country:US
Practice Address - Phone:316-258-2417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS373101YA0400X
KS185106H00000X
MO2021051210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)