Provider Demographics
NPI:1689443657
Name:HERRERA, LAURIN ALEXANDRA CASSANDRA (LMSW)
Entity Type:Individual
Prefix:
First Name:LAURIN ALEXANDRA
Middle Name:CASSANDRA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 BLACKHAW DR
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75087-9713
Mailing Address - Country:US
Mailing Address - Phone:256-998-2699
Mailing Address - Fax:
Practice Address - Street 1:295 BLACKHAW DR
Practice Address - Street 2:
Practice Address - City:FATE
Practice Address - State:TX
Practice Address - Zip Code:75087-9713
Practice Address - Country:US
Practice Address - Phone:256-998-2699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110434101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor