Healthcare Provider Details
I. General information
NPI: 1376864785
Provider Name (Legal Business Name): LAURA ELIZABETH MARIANI MA, LPC, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/21/2010
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
228 S MAIN AVE
SCRANTON PA
18504-2545
US
IV. Provider business mailing address
1092 BARDWELL RD
FACTORYVILLE PA
18419-7971
US
V. Phone/Fax
- Phone: 570-904-7363
- Fax:
- Phone: 857-453-0426
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: