Provider Demographics
NPI:1679088934
Name:MINOR, LAURA MONTELL (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MONTELL
Last Name:MINOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:MINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:979 COATBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-8525
Mailing Address - Country:US
Mailing Address - Phone:702-419-8083
Mailing Address - Fax:
Practice Address - Street 1:1515 EAST TROPICANA
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:702-898-5311
Practice Address - Fax:702-222-3275
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-08
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8764-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical