Provider Demographics
NPI:1871115576
Name:SALAZAR, LAURA ANNE (LCPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5226 LILLIAN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5227
Mailing Address - Country:US
Mailing Address - Phone:630-673-7983
Mailing Address - Fax:
Practice Address - Street 1:5226 LILLIAN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5227
Practice Address - Country:US
Practice Address - Phone:630-673-7983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012547101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor