Provider Demographics
NPI:1962861195
Name:LAICH, LAUREN KAY (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KAY
Last Name:LAICH
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-2335
Mailing Address - Country:US
Mailing Address - Phone:814-505-5749
Mailing Address - Fax:
Practice Address - Street 1:314 MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-2335
Practice Address - Country:US
Practice Address - Phone:814-505-5749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008761101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor