Provider Demographics
NPI:1124321609
Name:DIPETTE, LAURA (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DIPETTE
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4115 AVENUE O
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-6940
Mailing Address - Country:US
Mailing Address - Phone:409-762-8636
Mailing Address - Fax:409-938-4849
Practice Address - Street 1:4115 AVENUE O
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-6940
Practice Address - Country:US
Practice Address - Phone:409-762-8636
Practice Address - Fax:409-938-4849
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64757101YM0800X
TX201343101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health