Provider Demographics
NPI:1023795911
Name:KIRKLAND, LAURA CATHERINE (LMSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:CATHERINE
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 PARKVIEW GRV
Mailing Address - Street 2:
Mailing Address - City:KATHLEEN
Mailing Address - State:GA
Mailing Address - Zip Code:31047-5307
Mailing Address - Country:US
Mailing Address - Phone:478-841-0198
Mailing Address - Fax:
Practice Address - Street 1:139 PARKVIEW GRV
Practice Address - Street 2:
Practice Address - City:KATHLEEN
Practice Address - State:GA
Practice Address - Zip Code:31047-5307
Practice Address - Country:US
Practice Address - Phone:478-841-0198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW006370104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker