Provider Demographics
NPI:1619042926
Name:HOSKINS, LAURA MOODY (MA LCMHC NCC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MOODY
Last Name:HOSKINS
Suffix:
Gender:F
Credentials:MA LCMHC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-2678
Mailing Address - Country:US
Mailing Address - Phone:802-451-9557
Mailing Address - Fax:
Practice Address - Street 1:70 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-2678
Practice Address - Country:US
Practice Address - Phone:802-451-9557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0680000377101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1080746OtherCOVENTRY
VT1009979Medicaid