Provider Demographics
NPI:1942690383
Name:ABRAHAM, LAURA KATHLEEN (LPCC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHLEEN
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3670
Mailing Address - Country:US
Mailing Address - Phone:567-301-2037
Mailing Address - Fax:567-429-2040
Practice Address - Street 1:905 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3670
Practice Address - Country:US
Practice Address - Phone:567-301-2037
Practice Address - Fax:567-429-2040
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1700340101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0257169Medicaid