Provider Demographics
NPI:1669895579
Name:SCHOFF, LAURA CARLY
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:CARLY
Last Name:SCHOFF
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2746 LA BAJADA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-5332
Mailing Address - Country:US
Mailing Address - Phone:715-482-0256
Mailing Address - Fax:
Practice Address - Street 1:2055 S PACHECO ST STE 500
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3994
Practice Address - Country:US
Practice Address - Phone:505-701-8112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0209341101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional