Provider Demographics
NPI:1508116161
Name:AKINS, LAURA ELAINE (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ELAINE
Last Name:AKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6800
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75608-6800
Mailing Address - Country:US
Mailing Address - Phone:903-758-2471
Mailing Address - Fax:
Practice Address - Street 1:1085 PRIVATE ROAD 3481
Practice Address - Street 2:
Practice Address - City:BIG SANDY
Practice Address - State:TX
Practice Address - Zip Code:75755-5948
Practice Address - Country:US
Practice Address - Phone:903-636-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63236101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1356537377Medicaid