Provider Demographics
NPI:1649375775
Name:NEVILLE, LAURA N (LSCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:N
Last Name:NEVILLE
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:LAUA
Other - Middle Name:N
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSCSW
Mailing Address - Street 1:306 W 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BUHLER
Mailing Address - State:KS
Mailing Address - Zip Code:67522-9035
Mailing Address - Country:US
Mailing Address - Phone:620-543-6509
Mailing Address - Fax:
Practice Address - Street 1:1715 E 23RD AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1105
Practice Address - Country:US
Practice Address - Phone:620-665-2240
Practice Address - Fax:620-665-2276
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical