Provider Demographics
NPI:1760080931
Name:MATTHEWS, LAURA (LMHC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:BRUNELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC
Mailing Address - Street 1:9250 COLUMBIA AVE STE 2E
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-3530
Mailing Address - Country:US
Mailing Address - Phone:219-595-0043
Mailing Address - Fax:219-237-2894
Practice Address - Street 1:9250 COLUMBIA AVE STE 2E
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3530
Practice Address - Country:US
Practice Address - Phone:219-595-0043
Practice Address - Fax:219-237-2894
Is Sole Proprietor?:No
Enumeration Date:2020-10-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004448A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health