Provider Demographics
NPI:1801091749
Name:MCDERMOTT, LAURA JANELLE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JANELLE
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:JANELLE
Other - Last Name:CHANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5624 LINCOLN DR STE 295
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-1606
Mailing Address - Country:US
Mailing Address - Phone:612-987-8022
Mailing Address - Fax:612-465-1788
Practice Address - Street 1:5624 LINCOLN DR
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55436-1606
Practice Address - Country:US
Practice Address - Phone:952-395-3322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001175106H00000X
MN12047363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist