Provider Demographics
NPI:1497119762
Name:ACSADI, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ACSADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21512 W LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120-9110
Mailing Address - Country:US
Mailing Address - Phone:410-868-3516
Mailing Address - Fax:
Practice Address - Street 1:21512 W LIBERTY RD
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:MD
Practice Address - Zip Code:21120-9110
Practice Address - Country:US
Practice Address - Phone:410-868-3516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD217511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical