Provider Demographics
NPI:1891999181
Name:AXTELL, LAURA CONFER (MA, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:CONFER
Last Name:AXTELL
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5042 CRAMER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-8581
Mailing Address - Country:US
Mailing Address - Phone:704-824-4900
Mailing Address - Fax:
Practice Address - Street 1:5042 CRAMER WOODS DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-8581
Practice Address - Country:US
Practice Address - Phone:704-824-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2969101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health