Provider Demographics
NPI:1801611751
Name:GARISON, LAURA (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GARISON
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 1:1424 WHITEHALL DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-6747
Mailing Address - Country:US
Mailing Address - Phone:972-897-3864
Mailing Address - Fax:
Practice Address - Street 1:15851 DALLAS PKWY STE 600
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-6030
Practice Address - Country:US
Practice Address - Phone:469-514-0980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-16
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84104101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional