Provider Demographics
NPI:1316362734
Name:LAIDLAW, SAUNDRA O (MA, LADC, LPCC)
Entity type:Individual
Prefix:MRS
First Name:SAUNDRA
Middle Name:O
Last Name:LAIDLAW
Suffix:
Gender:F
Credentials:MA, LADC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 803
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56302-0803
Mailing Address - Country:US
Mailing Address - Phone:320-402-4747
Mailing Address - Fax:320-774-1979
Practice Address - Street 1:1411 W SAINT GERMAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4121
Practice Address - Country:US
Practice Address - Phone:320-402-4747
Practice Address - Fax:320-774-1979
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-21
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN303552101YA0400X
MNCC03060101YM0800X
MN3060101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN004550693OtherBLUE SHIELD
MN1316362734Medicaid