Healthcare Provider Details

I. General information

NPI: 1679803639
Provider Name (Legal Business Name): LAURA MARIE CHAMBERLIN MA, LPCC, ATR-BC, NC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2010
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 S 4TH ST STE 700
LOUISVILLE KY
40202-3046
US

IV. Provider business mailing address

4704 REDBUD FOREST PL
LOUISVILLE KY
40245-2110
US

V. Phone/Fax

Practice location:
  • Phone: 502-599-0821
  • Fax:
Mailing address:
  • Phone: 502-599-0821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number242957
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number61638486
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number14-056
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: