Provider Demographics
NPI:1922356005
Name:KESSLER, LAURA P (LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:P
Last Name:KESSLER
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 1:1910 E WAGONER RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-1365
Mailing Address - Country:US
Mailing Address - Phone:602-935-1020
Mailing Address - Fax:
Practice Address - Street 1:1910 E WAGONER RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-1365
Practice Address - Country:US
Practice Address - Phone:602-935-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-157651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ191028Medicaid
AZ191028Medicaid