Provider Demographics
NPI:1154623312
Name:FRANCO, LAURA COLUSSI (LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:COLUSSI
Last Name:FRANCO
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 1:122 HICKORY CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-8061
Mailing Address - Country:US
Mailing Address - Phone:754-800-3261
Mailing Address - Fax:813-689-3815
Practice Address - Street 1:710 OAKFIELD DR STE 206
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4954
Practice Address - Country:US
Practice Address - Phone:754-800-3261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-21
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 95631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical