Provider Demographics
NPI:1588166755
Name:SAPUTRA, LAURENCE (LPC)
Entity type:Individual
Prefix:MR
First Name:LAURENCE
Middle Name:
Last Name:SAPUTRA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4017 CROWN CT
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-7590
Mailing Address - Country:US
Mailing Address - Phone:817-937-8896
Mailing Address - Fax:
Practice Address - Street 1:101 S LOCUST ST STE 602
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-6159
Practice Address - Country:US
Practice Address - Phone:972-865-8782
Practice Address - Fax:972-499-6935
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75981101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health