Provider Demographics
NPI:1174556765
Name:LAJOS, LAURA ELAINE (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELAINE
Last Name:LAJOS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 UNIVERSITY PKWY STE 219
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2809
Mailing Address - Country:US
Mailing Address - Phone:800-687-1938
Mailing Address - Fax:727-495-7233
Practice Address - Street 1:2415 UNIVERSITY PKWY STE 219
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2809
Practice Address - Country:US
Practice Address - Phone:800-687-1938
Practice Address - Fax:727-495-7233
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA963103T00000X
FLPY8143103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1475777Medicaid
Q29617Medicare UPIN
LA1475777Medicaid