Healthcare Provider Details

I. General information

NPI: 1619418308
Provider Name (Legal Business Name): LAURA TOUGAS LCSW, MCAP, SAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2017
Last Update Date: 03/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 SE CENTRAL PKWY
STUART FL
34994-3904
US

IV. Provider business mailing address

959 SE CENTRAL PKWY
STUART FL
34994-3904
US

V. Phone/Fax

Practice location:
  • Phone: 772-286-8933
  • Fax: 772-286-8970
Mailing address:
  • Phone: 772-286-8933
  • Fax: 772-286-8970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW9305
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: