Provider Demographics
NPI:1699915223
Name:FENSTERSTOCK, LAURA SCHELL (MSSW)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:SCHELL
Last Name:FENSTERSTOCK
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 AINSDALE DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-6870
Mailing Address - Country:US
Mailing Address - Phone:704-844-8581
Mailing Address - Fax:
Practice Address - Street 1:2329 WEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-9253
Practice Address - Country:US
Practice Address - Phone:704-718-8657
Practice Address - Fax:704-821-4831
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0057671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical