Provider Demographics
NPI:1245652429
Name:DEKLE, LAURA L (LPCC-S, LICDC-CS)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:DEKLE
Suffix:
Gender:F
Credentials:LPCC-S, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 OLD HENDERSON RD STE 207
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3623
Mailing Address - Country:US
Mailing Address - Phone:614-348-8774
Mailing Address - Fax:614-846-6521
Practice Address - Street 1:1170 OLD HENDERSON RD STE 207
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3623
Practice Address - Country:US
Practice Address - Phone:614-348-8774
Practice Address - Fax:614-846-6521
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH131228101YA0400X
OHE3628101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)