Provider Demographics
NPI:1366766594
Name:BARBEAU, LAURA (MA, LAMFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BARBEAU
Suffix:
Gender:F
Credentials:MA, LAMFT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:RAE
Other - Last Name:BARBEAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4749 CHICAGO AVE
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-3556
Mailing Address - Country:US
Mailing Address - Phone:952-454-8325
Mailing Address - Fax:
Practice Address - Street 1:4749 CHICAGO AVE
Practice Address - Street 2:SUITE 4B
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3556
Practice Address - Country:US
Practice Address - Phone:952-454-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2017106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist