1346428216 NPI number — MRS. LAURA DANIEL LAWYER LCSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346428216 NPI number — MRS. LAURA DANIEL LAWYER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAWYER
Provider First Name:
LAURA
Provider Middle Name:
DANIEL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DANIEL
Provider Other First Name:
LAURA
Provider Other Middle Name:
JILL
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346428216
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2504 RAEFORD RD
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28305-5294
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-423-9900
Provider Business Mailing Address Fax Number:
910-423-0537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2504 RAEFORD RD
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28305-5294
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-423-9900
Provider Business Practice Location Address Fax Number:
910-423-0537
Provider Enumeration Date:
02/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C004483 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6106996 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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