Provider Demographics
NPI:1962565622
Name:ERHARDT, LAURA CHRISTINE (MS,LMFT,ND)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CHRISTINE
Last Name:ERHARDT
Suffix:
Gender:F
Credentials:MS,LMFT,ND
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:CHRISTINE
Other - Last Name:MACGEORGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:246 FEDERAL RD
Mailing Address - Street 2:SUITE C-24
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2647
Mailing Address - Country:US
Mailing Address - Phone:203-740-2595
Mailing Address - Fax:203-740-2287
Practice Address - Street 1:246 FEDERAL RD
Practice Address - Street 2:SUITE C-24
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2647
Practice Address - Country:US
Practice Address - Phone:203-740-2595
Practice Address - Fax:203-740-2287
Is Sole Proprietor?:No
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000218106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist