Provider Demographics
NPI:1639319353
Name:SMITH, LAURA LEIGH (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:LAURA LEIGH
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1833
Mailing Address - Country:US
Mailing Address - Phone:973-985-2665
Mailing Address - Fax:
Practice Address - Street 1:48 MAPLE ST
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-6505
Practice Address - Country:US
Practice Address - Phone:862-520-9836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-21
Last Update Date:2009-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00138800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional