Provider Demographics
NPI:1508337502
Name:HOLLOWELL, LAURA MORGAN (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MORGAN
Last Name:HOLLOWELL
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MORGAN
Other - Last Name:BICKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:927 N PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1020
Mailing Address - Country:US
Mailing Address - Phone:317-686-5800
Mailing Address - Fax:
Practice Address - Street 1:927 N PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1020
Practice Address - Country:US
Practice Address - Phone:317-686-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003167A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health