Provider Demographics
NPI:1265241418
Name:WOODS, LAURA DEANNA (LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:DEANNA
Last Name:WOODS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1010 WHITE CIR
Mailing Address - Street 2:
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-5054
Mailing Address - Country:US
Mailing Address - Phone:662-417-9313
Mailing Address - Fax:
Practice Address - Street 1:1010 WHITE CIR
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-5054
Practice Address - Country:US
Practice Address - Phone:662-417-9313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC113891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical