Provider Demographics
NPI:1922625649
Name:LAWSON, LARONICA SHONTA (MBA)
Entity Type:Individual
Prefix:
First Name:LARONICA
Middle Name:SHONTA
Last Name:LAWSON
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17127 PITON WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-5409
Mailing Address - Country:US
Mailing Address - Phone:502-640-3360
Mailing Address - Fax:
Practice Address - Street 1:17127 PITON WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-5409
Practice Address - Country:US
Practice Address - Phone:502-640-3360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional