Healthcare Provider Details

I. General information

NPI: 1407561137
Provider Name (Legal Business Name): LAUREL NOOK MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 55
SALIDA CO
81201-0055
US

IV. Provider business mailing address

PO BOX 55
SALIDA CO
81201-0055
US

V. Phone/Fax

Practice location:
  • Phone: 720-233-0353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number0019614
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: