Provider Demographics
NPI:1811593858
Name:KLUEPPEL, LAURA BEATRIX (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BEATRIX
Last Name:KLUEPPEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 ELMRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3565
Mailing Address - Country:US
Mailing Address - Phone:469-285-1227
Mailing Address - Fax:
Practice Address - Street 1:307 N GLENWOOD BLVD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-5428
Practice Address - Country:US
Practice Address - Phone:903-707-2031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-06
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81339101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional