Provider Demographics
NPI:1265996391
Name:ZARANDONA, LAURA ELENA (MS, LMHC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ELENA
Last Name:ZARANDONA
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W MCKINLEY AVE STE 318
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-5651
Mailing Address - Country:US
Mailing Address - Phone:574-397-3456
Mailing Address - Fax:574-607-3009
Practice Address - Street 1:310 W MCKINLEY AVE STE 318
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-5651
Practice Address - Country:US
Practice Address - Phone:574-397-3456
Practice Address - Fax:574-607-3009
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003161A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty