Provider Demographics
NPI:1770521288
Name:KRUTHOFFER, LAURA C (LPCC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:C
Last Name:KRUTHOFFER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 FARRELL CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45233-1677
Mailing Address - Country:US
Mailing Address - Phone:513-451-6871
Mailing Address - Fax:513-451-6876
Practice Address - Street 1:425 FARRELL CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45233-1677
Practice Address - Country:US
Practice Address - Phone:513-451-6871
Practice Address - Fax:513-451-6876
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0250101Y00000X
OHE.0500597101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY184607OtherMEDICARE GROUP NUMBER