Provider Demographics
NPI:1710153119
Name:LAFORTE, LAURA W (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:W
Last Name:LAFORTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1334
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83701-1334
Mailing Address - Country:US
Mailing Address - Phone:206-953-3708
Mailing Address - Fax:
Practice Address - Street 1:1555 W SHORELINE DR STE 100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-9107
Practice Address - Country:US
Practice Address - Phone:206-953-3708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000058471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical