Provider Demographics
NPI:1760127559
Name:HARDING, LAUREL (MS, PLSW)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:HARDING
Suffix:
Gender:F
Credentials:MS, PLSW
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:
Other - Last Name:GROVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:72 BUGLE LN
Mailing Address - Street 2:
Mailing Address - City:KEARNEYSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25430-4754
Mailing Address - Country:US
Mailing Address - Phone:304-839-0609
Mailing Address - Fax:
Practice Address - Street 1:1020 WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-1650
Practice Address - Country:US
Practice Address - Phone:304-886-4118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPL082115998104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker