Provider Demographics
NPI:1487103610
Name:FIELD, LAURA CHRISTINE (MSW)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:CHRISTINE
Last Name:FIELD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:CHRISTINE
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:6325 CHERRY BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49685-5000
Mailing Address - Country:US
Mailing Address - Phone:231-631-7674
Mailing Address - Fax:231-946-0451
Practice Address - Street 1:6325 CHERRY BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49685-5000
Practice Address - Country:US
Practice Address - Phone:231-631-7674
Practice Address - Fax:231-946-0451
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801085161104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker