Provider Demographics
NPI:1942378732
Name:SAUBER, LAURIE H (MSW)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:H
Last Name:SAUBER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6327 SETON HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-4523
Mailing Address - Country:US
Mailing Address - Phone:704-847-8268
Mailing Address - Fax:704-847-8329
Practice Address - Street 1:6817 FAIRVIEW RD STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3598
Practice Address - Country:US
Practice Address - Phone:704-365-6260
Practice Address - Fax:704-365-6266
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0007581041C0700X
MA1062181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical