Provider Demographics
NPI:1982314217
Name:WINKLES, LAURA MIXON (MS, ALC, NCC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MIXON
Last Name:WINKLES
Suffix:
Gender:F
Credentials:MS, ALC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2973 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5811
Mailing Address - Country:US
Mailing Address - Phone:412-867-6995
Mailing Address - Fax:
Practice Address - Street 1:3055 LORNA RD STE 200
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-4513
Practice Address - Country:US
Practice Address - Phone:205-202-9893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04292101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health