Provider Demographics
NPI:1801212337
Name:STANLEY, LAURA KAY (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KAY
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 LAWRENCEVILLE SUWANEE RD STE D
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6425
Mailing Address - Country:US
Mailing Address - Phone:678-227-2991
Mailing Address - Fax:
Practice Address - Street 1:3455 LAWRENCEVILLE SUWANEE RD STE D
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6425
Practice Address - Country:US
Practice Address - Phone:678-227-2991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-07
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002918101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional