Provider Demographics
NPI:1891439535
Name:LAHAY, LAURA ROSE
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ROSE
Last Name:LAHAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-6932
Mailing Address - Country:US
Mailing Address - Phone:812-483-4538
Mailing Address - Fax:
Practice Address - Street 1:1950 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3114
Practice Address - Country:US
Practice Address - Phone:630-570-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional