Provider Demographics
NPI:1912454109
Name:MACLEAN, LAURA (LISW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MACLEAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 TOWN CENTER LOOP
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7696
Mailing Address - Country:US
Mailing Address - Phone:614-209-0013
Mailing Address - Fax:
Practice Address - Street 1:18 W COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1256
Practice Address - Country:US
Practice Address - Phone:614-924-0363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.18023051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical