Provider Demographics
NPI:1508554205
Name:LAUB, CATHLEEN (LMHC-A)
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:
Last Name:LAUB
Suffix:
Gender:F
Credentials:LMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23521 WOODBURN RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46797-9740
Mailing Address - Country:US
Mailing Address - Phone:260-573-6355
Mailing Address - Fax:
Practice Address - Street 1:23521 WOODBURN RD
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:IN
Practice Address - Zip Code:46797-9740
Practice Address - Country:US
Practice Address - Phone:260-573-6355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99115538A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health