Provider Demographics
NPI:1760561567
Name:GOMEZ-HORTON, LAURA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:GOMEZ-HORTON
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 1:2219 KLATTENHOFF DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-5480
Mailing Address - Country:US
Mailing Address - Phone:512-965-0830
Mailing Address - Fax:
Practice Address - Street 1:2015 S IH 35 STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-3810
Practice Address - Country:US
Practice Address - Phone:512-326-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical