Provider Demographics
NPI:1710259528
Name:EASLAND, LAUREY ANN (LMSW, CTRS, MT-BC)
Entity Type:Individual
Prefix:
First Name:LAUREY
Middle Name:ANN
Last Name:EASLAND
Suffix:
Gender:F
Credentials:LMSW, CTRS, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 LEXINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-9108
Mailing Address - Country:US
Mailing Address - Phone:319-653-6161
Mailing Address - Fax:319-863-1311
Practice Address - Street 1:2175 LEXINGTON BLVD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-9108
Practice Address - Country:US
Practice Address - Phone:319-653-6161
Practice Address - Fax:319-863-1311
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007805104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker