Provider Demographics
NPI:1982774907
Name:JANSON, LAURA E (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:JANSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BONNIE LANE
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-8511
Mailing Address - Country:US
Mailing Address - Phone:828-586-5501
Mailing Address - Fax:828-586-3965
Practice Address - Street 1:44 BONNIE LANE
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-0127
Practice Address - Country:US
Practice Address - Phone:828-586-5501
Practice Address - Fax:828-586-3965
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0028521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2878719OtherMEDICARE
NC132VKOtherBCBS OF NORTH CAROLINA