Healthcare Provider Details

I. General information

NPI: 1750763306
Provider Name (Legal Business Name): LINDSAY BROOKE LAUFER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3552 BEATTIES FORD RD
CHARLOTTE NC
28216-3742
US

IV. Provider business mailing address

3552 BEATTIES FORD RD
CHARLOTTE NC
28216-3742
US

V. Phone/Fax

Practice location:
  • Phone: 704-394-8968
  • Fax:
Mailing address:
  • Phone: 704-394-8968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW 8894
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC013409
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: