Provider Demographics
NPI:1154163517
Name:RICH, LAURA T (LCMHC-A)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:T
Last Name:RICH
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 FISH DR
Mailing Address - Street 2:
Mailing Address - City:ANGIER
Mailing Address - State:NC
Mailing Address - Zip Code:27501-6077
Mailing Address - Country:US
Mailing Address - Phone:910-240-4599
Mailing Address - Fax:919-516-9793
Practice Address - Street 1:215 FISH DR
Practice Address - Street 2:
Practice Address - City:ANGIER
Practice Address - State:NC
Practice Address - Zip Code:27501-6077
Practice Address - Country:US
Practice Address - Phone:910-240-4599
Practice Address - Fax:919-516-9793
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20089101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional