Provider Demographics
NPI:1831526086
Name:MINDELL, LAURA SHIRA (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:SHIRA
Last Name:MINDELL
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:PO BOX 2042
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-2042
Mailing Address - Country:US
Mailing Address - Phone:248-253-7476
Mailing Address - Fax:248-282-0666
Practice Address - Street 1:25882 ORCHARD LAKE RD STE 202
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1295
Practice Address - Country:US
Practice Address - Phone:248-325-7476
Practice Address - Fax:248-282-0666
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013930101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional