Provider Demographics
NPI:1336369883
Name:ESTES, LAURALEE GRACE (MED, MDIV)
Entity Type:Individual
Prefix:MRS
First Name:LAURALEE
Middle Name:GRACE
Last Name:ESTES
Suffix:
Gender:F
Credentials:MED, MDIV
Other - Prefix:MRS
Other - First Name:LAURALEE
Other - Middle Name:STAPP
Other - Last Name:ESTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, CPC, MDIV
Mailing Address - Street 1:1675 MONTCLAIR RD
Mailing Address - Street 2:EASTWOOD BUILDING, SUITE 252
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2407
Mailing Address - Country:US
Mailing Address - Phone:205-588-6347
Mailing Address - Fax:205-588-6384
Practice Address - Street 1:1675 MONTCLAIR RD
Practice Address - Street 2:EASTWOOD BUILDING, SUITE 252
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35210-2407
Practice Address - Country:US
Practice Address - Phone:205-588-6347
Practice Address - Fax:205-588-6384
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4539101YP1600X
AL#177106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral