Provider Demographics
NPI:1265718811
Name:RAND, LAURA S (LPCA)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:S
Last Name:RAND
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 CHURCHILL DOWNS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-9763
Mailing Address - Country:US
Mailing Address - Phone:828-216-3357
Mailing Address - Fax:
Practice Address - Street 1:126 CHURCHILL DOWNS DR
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-9763
Practice Address - Country:US
Practice Address - Phone:828-216-3357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9070101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health