Provider Demographics
NPI:1780745927
Name:LAIRD, LOUISA V (LCSW)
Entity type:Individual
Prefix:MS
First Name:LOUISA
Middle Name:V
Last Name:LAIRD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 DOLAN DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-5201
Mailing Address - Country:US
Mailing Address - Phone:912-507-1680
Mailing Address - Fax:912-999-6604
Practice Address - Street 1:110 E 55TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-3320
Practice Address - Country:US
Practice Address - Phone:912-354-8616
Practice Address - Fax:912-999-6604
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000633104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA80BBPJPMedicare ID - Type Unspecified