Healthcare Provider Details

I. General information

NPI: 1760528996
Provider Name (Legal Business Name): LAURA DANIELLE ESTES MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. LAURA DANIELLE GUIGNON

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 12/18/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7204 SKYWAY
PARADISE CA
95969
US

IV. Provider business mailing address

10 S EUCLID AVE STE C
SAINT LOUIS MO
63108-3809
US

V. Phone/Fax

Practice location:
  • Phone: 530-872-2103
  • Fax: 530-872-7784
Mailing address:
  • Phone: 552-847-4838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLCSW2004005801
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberLCSW2004005801
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20040058013
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: