Provider Demographics
NPI:1982243572
Name:SUMMERS, LAURA (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 W LOVERS LN STE 317
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-4329
Mailing Address - Country:US
Mailing Address - Phone:469-597-8879
Mailing Address - Fax:
Practice Address - Street 1:5600 W LOVERS LN STE 317
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-4329
Practice Address - Country:US
Practice Address - Phone:469-597-8879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE