Provider Demographics
NPI:1356103063
Name:KLEEMOOK, LAURA CATHERINE (LPC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:CATHERINE
Last Name:KLEEMOOK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 CENTREVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-3705
Mailing Address - Country:US
Mailing Address - Phone:724-406-8571
Mailing Address - Fax:
Practice Address - Street 1:339 CENTREVILLE PIKE
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-3705
Practice Address - Country:US
Practice Address - Phone:724-406-8571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016636101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional