Provider Demographics
NPI:1447487814
Name:DEAN, LAURA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 EDGEWOOD DR SE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:OR
Mailing Address - Zip Code:97352-9215
Mailing Address - Country:US
Mailing Address - Phone:503-313-2479
Mailing Address - Fax:503-313-2479
Practice Address - Street 1:250 BROADALBIN ST SW
Practice Address - Street 2:STE 245
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2295
Practice Address - Country:US
Practice Address - Phone:503-313-2479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR44521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical