Provider Demographics
NPI:1881142339
Name:HACKMAN, LAURA (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:HACKMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40744 INWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-5655
Mailing Address - Country:US
Mailing Address - Phone:310-701-9419
Mailing Address - Fax:
Practice Address - Street 1:40744 INWOOD CT
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-5655
Practice Address - Country:US
Practice Address - Phone:310-701-9419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW729571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical