Provider Demographics
NPI:1386895902
Name:DANIELS, LAURA MARIE (LIMHP, LISW, CMSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LIMHP, LISW, CMSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MARIE
Other - Last Name:HAGEBUSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LIMHP, LISW, CMSW
Mailing Address - Street 1:11909 P ST STE 105
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2235
Mailing Address - Country:US
Mailing Address - Phone:402-810-1914
Mailing Address - Fax:
Practice Address - Street 1:11909 P ST STE 105
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2235
Practice Address - Country:US
Practice Address - Phone:402-810-1914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0101YA0400X
101YM0800X
IA1019761041C0700X
KS117831041C0700X
NE31651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health