Provider Demographics
NPI:1689249245
Name:LAING, JODI (LPC)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:LAING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:BRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:QMHP
Mailing Address - Street 1:PO BOX 3258
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-0710
Mailing Address - Country:US
Mailing Address - Phone:541-903-8026
Mailing Address - Fax:
Practice Address - Street 1:1900 16TH AVE SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1832
Practice Address - Country:US
Practice Address - Phone:541-903-8026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7637101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional