Provider Demographics
NPI:1689935124
Name:KOLBUS, LAURA R (LMHC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:R
Last Name:KOLBUS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:R
Other - Last Name:SHERER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:615 N ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1430
Mailing Address - Country:US
Mailing Address - Phone:317-634-6341
Mailing Address - Fax:317-464-9575
Practice Address - Street 1:615 N ALABAMA ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1430
Practice Address - Country:US
Practice Address - Phone:317-634-6341
Practice Address - Fax:317-464-9575
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33005787A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health