Provider Demographics
NPI:1992742332
Name:WINCHESTER, LAURA LOUISE (LCSW, CEAP)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LOUISE
Last Name:WINCHESTER
Suffix:
Gender:F
Credentials:LCSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20844
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73156-0844
Mailing Address - Country:US
Mailing Address - Phone:405-463-5511
Mailing Address - Fax:405-463-5571
Practice Address - Street 1:11212 N MAY AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6336
Practice Address - Country:US
Practice Address - Phone:405-463-5511
Practice Address - Fax:405-463-5571
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical