Provider Demographics
NPI:1689948259
Name:CARNEVALE, LAURA LYNN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LYNN
Last Name:CARNEVALE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3944 RED ROCK LN
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-3541
Mailing Address - Country:US
Mailing Address - Phone:941-586-4870
Mailing Address - Fax:941-586-4870
Practice Address - Street 1:3944 RED ROCK LN
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3541
Practice Address - Country:US
Practice Address - Phone:941-586-4870
Practice Address - Fax:941-586-4870
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11152101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health