Provider Demographics
NPI:1417398165
Name:MCLAIN, LAURA MINCH (PSY, D)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MINCH
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:PSY, D
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MICHELLE
Other - Last Name:MINCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:50 GLENLAKE PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3486
Mailing Address - Country:US
Mailing Address - Phone:678-328-4100
Mailing Address - Fax:770-671-8508
Practice Address - Street 1:50 GLENLAKE PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3486
Practice Address - Country:US
Practice Address - Phone:678-328-4100
Practice Address - Fax:770-671-8508
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003681103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical