Provider Demographics
NPI:1952671331
Name:KOGELSCHATZ, LAURA MARIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:KOGELSCHATZ
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 KENILWORTH DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2312
Mailing Address - Country:US
Mailing Address - Phone:410-740-8066
Mailing Address - Fax:
Practice Address - Street 1:658 KENILWORTH DRIVE
Practice Address - Street 2:SUITE 206
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4421
Practice Address - Country:US
Practice Address - Phone:443-668-7136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical