Provider Demographics
NPI:1336303379
Name:FLACCUS, LAURA SUE (MSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:SUE
Last Name:FLACCUS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:SUE
Other - Last Name:MOREAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:113 DOREE LN
Mailing Address - Street 2:
Mailing Address - City:CROUSE
Mailing Address - State:NC
Mailing Address - Zip Code:28033-9705
Mailing Address - Country:US
Mailing Address - Phone:980-329-4649
Mailing Address - Fax:
Practice Address - Street 1:101 GOVERNMENT AVE SW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-2936
Practice Address - Country:US
Practice Address - Phone:828-624-4135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health