Provider Demographics
NPI:1588425508
Name:LAURA L. DEKLE, LPCC-S, LICDC-CS, LLC
Entity type:Organization
Organization Name:LAURA L. DEKLE, LPCC-S, LICDC-CS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEKLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S, LICDC-CS
Authorized Official - Phone:614-348-8774
Mailing Address - Street 1:1170 OLD HENDERSON RD STE 207
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3623
Mailing Address - Country:US
Mailing Address - Phone:614-348-8774
Mailing Address - Fax:614-846-6521
Practice Address - Street 1:1170 OLD HENDERSON RD STE 207
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3623
Practice Address - Country:US
Practice Address - Phone:614-348-8774
Practice Address - Fax:614-846-6521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty