Provider Demographics
NPI:1942607783
Name:YORK, LAURA MICHELLE (MA, ATR-BC, LPC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MICHELLE
Last Name:YORK
Suffix:
Gender:F
Credentials:MA, ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 W GIRARD AVE FRNT
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1637
Mailing Address - Country:US
Mailing Address - Phone:215-490-6617
Mailing Address - Fax:
Practice Address - Street 1:1615 W GIRARD AVE FRNT
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-1637
Practice Address - Country:US
Practice Address - Phone:215-490-6617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 102L00000X, 1041C0700X
PA007186101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical