Provider Demographics
NPI:1649402736
Name:PEPPARD, LAURA ANN (LMHC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:PEPPARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8461 LAKE WORTH RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2474
Mailing Address - Country:US
Mailing Address - Phone:561-839-1896
Mailing Address - Fax:561-839-1899
Practice Address - Street 1:8461 LAKE WORTH RD
Practice Address - Street 2:SUITE 104
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2474
Practice Address - Country:US
Practice Address - Phone:561-839-1896
Practice Address - Fax:561-839-1899
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-22
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8846101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health