Provider Demographics
NPI:1427132364
Name:MARTIN- WOLF, LAURA (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MARTIN- WOLF
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9525 KATY FWY
Mailing Address - Street 2:SUITE 311
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1407
Mailing Address - Country:US
Mailing Address - Phone:713-463-9449
Mailing Address - Fax:713-395-1429
Practice Address - Street 1:9525 KATY FWY
Practice Address - Street 2:SUITE 424
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1407
Practice Address - Country:US
Practice Address - Phone:713-463-9449
Practice Address - Fax:713-395-1429
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15249101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXLPC15249OtherBENEFIT PLANNERS
TX10008917OtherAMERIGROUP
TX6397LCOtherBLUE CROSS BLUE SHIELD