Provider Demographics
NPI:1699072587
Name:CALABRESE, LAURA BETH (LICSW)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:BETH
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:BETH
Other - Last Name:DAVIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1555 55TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHOUGAL
Mailing Address - State:WA
Mailing Address - Zip Code:98671-6806
Mailing Address - Country:US
Mailing Address - Phone:360-335-4805
Mailing Address - Fax:
Practice Address - Street 1:1555 55TH ST
Practice Address - Street 2:
Practice Address - City:WASHOUGAL
Practice Address - State:WA
Practice Address - Zip Code:98671-6806
Practice Address - Country:US
Practice Address - Phone:360-335-4805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA729851041C0700X
WASWI.LW.612142031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker