Provider Demographics
NPI:1447551858
Name:NORDONE, LAURA M
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:NORDONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 WELLESLEY DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1812
Mailing Address - Country:US
Mailing Address - Phone:505-766-9361
Mailing Address - Fax:505-243-2252
Practice Address - Street 1:2400 WELLESLEY DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1812
Practice Address - Country:US
Practice Address - Phone:505-766-9361
Practice Address - Fax:505-243-2252
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM09002101YM0800X, 1041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health