Provider Demographics
NPI:1518002138
Name:TRUSLOW, LAURA ALEXIS (LMHC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ALEXIS
Last Name:TRUSLOW
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:TRUSLOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LHMC
Mailing Address - Street 1:103 BLISS STREET
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2605
Mailing Address - Country:US
Mailing Address - Phone:413-584-2919
Mailing Address - Fax:
Practice Address - Street 1:53 CENTER ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:413-584-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALM1298OtherBCBS MA