Provider Demographics
NPI:1588223416
Name:ADAMS, LAURA ANN (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-3357
Mailing Address - Country:US
Mailing Address - Phone:208-284-8999
Mailing Address - Fax:
Practice Address - Street 1:4144 E AMITY AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-8802
Practice Address - Country:US
Practice Address - Phone:208-960-7030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-7258101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health