Provider Demographics
NPI:1487730248
Name:CARDAMONE, LAURA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:CARDAMONE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17187 CANVASBACK DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-7411
Mailing Address - Country:US
Mailing Address - Phone:586-216-5837
Mailing Address - Fax:
Practice Address - Street 1:198 S MAIN ST
Practice Address - Street 2:STE 2
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-7917
Practice Address - Country:US
Practice Address - Phone:586-466-5960
Practice Address - Fax:586-466-5960
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010576621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical