Provider Demographics
NPI:1538311493
Name:PRYOR, LAURA MICHELLE (LIMHP, LPC, PLADC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MICHELLE
Last Name:PRYOR
Suffix:
Gender:F
Credentials:LIMHP, LPC, PLADC
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:MICHELLE
Other - Last Name:WIESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LIMHP, LPC, PLADC
Mailing Address - Street 1:7909 L ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1725
Mailing Address - Country:US
Mailing Address - Phone:402-981-2177
Mailing Address - Fax:402-934-3801
Practice Address - Street 1:7909 L ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1725
Practice Address - Country:US
Practice Address - Phone:402-981-2177
Practice Address - Fax:402-934-3801
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8655101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional