Provider Demographics
NPI:1245440866
Name:DELANEY, LAURA MICHELLE (LCSW-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MICHELLE
Last Name:DELANEY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MICHELLE
Other - Last Name:WILMOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11525 SUNBURST MARBLE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-2119
Mailing Address - Country:US
Mailing Address - Phone:813-252-0978
Mailing Address - Fax:813-756-2832
Practice Address - Street 1:11525 SUNBURST MARBLE RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-2119
Practice Address - Country:US
Practice Address - Phone:813-252-0978
Practice Address - Fax:813-756-2832
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD128561041C0700X
FLSW146151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical