Provider Demographics
NPI:1578187605
Name:LAIRD, DANA ELIZABETH (MA, LPC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ELIZABETH
Last Name:LAIRD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 RIVERDALE PARK CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-1548
Mailing Address - Country:US
Mailing Address - Phone:314-297-0715
Mailing Address - Fax:
Practice Address - Street 1:332A JUNGERMANN RD
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-5303
Practice Address - Country:US
Practice Address - Phone:314-297-0715
Practice Address - Fax:636-244-0722
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020010977101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional