Provider Demographics
NPI:1831331115
Name:ANDERSON, LAURA ANN (LMHC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:ANDERSON
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:SEAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2516 SUNFLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-5932
Mailing Address - Country:US
Mailing Address - Phone:904-229-7940
Mailing Address - Fax:
Practice Address - Street 1:2516 SUNFLOWER AVE
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-5932
Practice Address - Country:US
Practice Address - Phone:904-229-7940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FLMH14878101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator