Provider Demographics
NPI:1669247144
Name:MOBLEY, LAURA HEWITT (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:HEWITT
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 DOC DARBYSHIRE ROAD
Mailing Address - Street 2:PMB #126
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31788
Mailing Address - Country:US
Mailing Address - Phone:229-234-7141
Mailing Address - Fax:
Practice Address - Street 1:211 TALLOKAS RD
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31768-5964
Practice Address - Country:US
Practice Address - Phone:229-234-7141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0087851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical