Provider Demographics
NPI:1174924641
Name:THORSTEN, LAURA (LPC)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:THORSTEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WATERWAY AVE APT 1151
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3453
Mailing Address - Country:US
Mailing Address - Phone:832-563-4279
Mailing Address - Fax:
Practice Address - Street 1:25511 BUDDE RD
Practice Address - Street 2:SUITE #502
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2080
Practice Address - Country:US
Practice Address - Phone:832-563-4279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67408101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional