Provider Demographics
NPI:1851384481
Name:BRIGHT, LAURA LEE (LISW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:312 E ALTA VISTA AVE
Mailing Address - Street 2:BEHAVIORAL HEALTH COUNSELING SERVICES
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-1413
Mailing Address - Country:US
Mailing Address - Phone:641-684-3138
Mailing Address - Fax:641-684-3198
Practice Address - Street 1:312 E ALTA VISTA AVE
Practice Address - Street 2:BEHAVIORAL HEALTH COUNSELING SERVICES
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-1413
Practice Address - Country:US
Practice Address - Phone:641-684-3138
Practice Address - Fax:641-684-3198
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05781104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0268714Medicaid
IA42068106081OtherJOHN DEERE HEALTH
IA207478OtherIOWA HEALTH SOLUTIONS
IAI023OtherTRIWEST
IA800013273OtherRAILROAD MEDICARE
IA42068106081OtherUNITED BEHAVIORAL HEALTH
IA55716OtherWELLMARK INC BCBS OF IOWA
IA0268714Medicaid
IAI023OtherTRIWEST