Provider Demographics
NPI:1316453434
Name:DAVIS, LAURA C (MS, LPCC, LADC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:C
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MS, LPCC, LADC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:C
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPCC, LADC
Mailing Address - Street 1:680 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-4117
Mailing Address - Country:US
Mailing Address - Phone:651-292-2412
Mailing Address - Fax:
Practice Address - Street 1:680 STEWART AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-4117
Practice Address - Country:US
Practice Address - Phone:651-292-2412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00511101YM0800X
MN301702101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health