Provider Demographics
NPI:1710424189
Name:LAUX, KATIE (MLADC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:LAUX
Suffix:
Gender:F
Credentials:MLADC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:LAUX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:122 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1952
Mailing Address - Country:US
Mailing Address - Phone:603-641-9441
Mailing Address - Fax:
Practice Address - Street 1:161 S BEECH ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-5708
Practice Address - Country:US
Practice Address - Phone:603-641-9441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NH0130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor