Provider Demographics
NPI:1790137420
Name:MCLAUGHLIN, LAURA LEE (LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:MCLAUGHLIN
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 1:6655 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-7654
Mailing Address - Country:US
Mailing Address - Phone:850-556-7088
Mailing Address - Fax:
Practice Address - Street 1:6655 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32583-7654
Practice Address - Country:US
Practice Address - Phone:850-556-7088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW145871041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical