Healthcare Provider Details

I. General information

NPI: 1356263321
Provider Name (Legal Business Name): LAURA ANN OMEARA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 CAMBRIDGE RD
ENTERPRISE AL
36330-7011
US

IV. Provider business mailing address

112 CAMBRIDGE RD
ENTERPRISE AL
36330-7011
US

V. Phone/Fax

Practice location:
  • Phone: 334-406-1429
  • Fax:
Mailing address:
  • Phone: 334-406-1429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC04968
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: