Provider Demographics
NPI:1881372118
Name:MCLAURIN, TAWANDA (LCSWA)
Entity type:Individual
Prefix:
First Name:TAWANDA
Middle Name:
Last Name:MCLAURIN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 SHEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-0526
Mailing Address - Country:US
Mailing Address - Phone:910-286-2666
Mailing Address - Fax:
Practice Address - Street 1:2060 GOINS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-2169
Practice Address - Country:US
Practice Address - Phone:910-339-9337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0175091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical