=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043372626
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURA JANEL SOKOL LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1232 E BROADWAY RD STE 120
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85282-1510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-784-1514
-----------------------------------------------------
Fax | 623-915-2099
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3320 W MCRAE WAY UNIT 5
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85027-4873
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-322-9265
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | LPC-12391
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------