Provider Demographics
NPI:1679803639
Name:CHAMBERLIN, LAURA MARIE (MA, LPCC, LPAT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:CHAMBERLIN
Suffix:
Gender:F
Credentials:MA, LPCC, LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2202
Mailing Address - Country:US
Mailing Address - Phone:502-585-9466
Mailing Address - Fax:
Practice Address - Street 1:950 S 1ST ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2202
Practice Address - Country:US
Practice Address - Phone:502-585-9466
Practice Address - Fax:360-856-3065
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY242957101YP2500X
KY168407221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional