Provider Demographics
NPI:1659579761
Name:PLACEK, LAURA KAHL (MS LPC CADCIII CMHC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KAHL
Last Name:PLACEK
Suffix:
Gender:F
Credentials:MS LPC CADCIII CMHC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:KAHL-PLACEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAURA PLACEK
Mailing Address - Street 1:38569 CASCADIA VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-5389
Mailing Address - Country:US
Mailing Address - Phone:608-214-0862
Mailing Address - Fax:503-203-8095
Practice Address - Street 1:38569 CASCADIA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-5389
Practice Address - Country:US
Practice Address - Phone:608-214-0862
Practice Address - Fax:503-203-8095
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4778101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health