Provider Demographics
NPI:1487204210
Name:VELAS, LAURA ANN (LSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:VELAS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 S 4TH ST STE 471
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1582
Mailing Address - Country:US
Mailing Address - Phone:267-861-3685
Mailing Address - Fax:215-965-1513
Practice Address - Street 1:525 S 4TH ST STE 471
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1582
Practice Address - Country:US
Practice Address - Phone:267-861-3685
Practice Address - Fax:215-965-1513
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW136271104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker