Provider Demographics
NPI:1730432824
Name:BYROM, LAURA CALDWELL (LSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:CALDWELL
Last Name:BYROM
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 FREEDOM CT
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44904-1690
Mailing Address - Country:US
Mailing Address - Phone:567-241-6339
Mailing Address - Fax:
Practice Address - Street 1:788 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1921
Practice Address - Country:US
Practice Address - Phone:419-526-5523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1201203104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker