Provider Demographics
NPI:1760826077
Name:LAUGHLIN, CHERYL C (BA)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:C
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2331 CAREY ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-3627
Mailing Address - Country:US
Mailing Address - Phone:985-646-6406
Mailing Address - Fax:
Practice Address - Street 1:835 PRIDE DR STE B
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-9527
Practice Address - Country:US
Practice Address - Phone:985-646-6406
Practice Address - Fax:985-543-4817
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA9867544676Medicaid