Provider Demographics
NPI:1942642335
Name:HIGHTOWER, LAUREL (LICSW)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:
Other - Last Name:KIRBAWY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1660 S 39TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-1760
Mailing Address - Country:US
Mailing Address - Phone:253-226-8196
Mailing Address - Fax:
Practice Address - Street 1:2420 S UNION AVE STE 100
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1306
Practice Address - Country:US
Practice Address - Phone:253-752-7320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
WALW613859171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator