Provider Demographics
NPI:1871508457
Name:WEYRENS, LAURA GRACE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:GRACE
Last Name:WEYRENS
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 1:415 N MCKINLEY ST
Mailing Address - Street 2:SUITE 1060
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3013
Mailing Address - Country:US
Mailing Address - Phone:501-537-2200
Mailing Address - Fax:501-537-2202
Practice Address - Street 1:415 N MCKINLEY ST
Practice Address - Street 2:SUITE 1060
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3013
Practice Address - Country:US
Practice Address - Phone:501-537-2200
Practice Address - Fax:501-537-2202
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1671-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical