Provider Demographics
NPI:1699003657
Name:WOOD, LAURA J (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:J
Last Name:WOOD
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:J
Other - Last Name:MIDDLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:905 GREENE COUNTY OFFICE BUILDING
Mailing Address - Street 2:GREENE COUNTY MENTAL HEALTH CENTER
Mailing Address - City:CAIRO
Mailing Address - State:NY
Mailing Address - Zip Code:12413-2868
Mailing Address - Country:US
Mailing Address - Phone:518-622-9163
Mailing Address - Fax:518-622-8592
Practice Address - Street 1:905 GREENE COUNTY OFFICE BLDG
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:NY
Practice Address - Zip Code:12413-2868
Practice Address - Country:US
Practice Address - Phone:518-622-9163
Practice Address - Fax:518-622-8592
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079943-11041C0700X
NY0819711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical