Provider Demographics
NPI:1457725269
Name:WISDOM, LAURA LEA (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEA
Last Name:WISDOM
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 1:2136 SW RAMBLING VINE RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-4140
Mailing Address - Country:US
Mailing Address - Phone:816-682-5955
Mailing Address - Fax:
Practice Address - Street 1:10550 MARTY ST
Practice Address - Street 2:ASAP EXPERT COUNSELING LLC
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-2557
Practice Address - Country:US
Practice Address - Phone:913-952-6696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC 2856101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor