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General NPI Number Information
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NPI Number | 1588166755
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Entity Type | Individual
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Provider Name | LAURENCE SAPUTRA LPC
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Gender | Male
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Dates
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Enumeration Date | 03/05/2018
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 101 S LOCUST ST STE 602
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City | DENTON
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State | TX
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Zip | 76201-6159
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Country | US
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Telephone | 972-865-8782
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Fax | 972-499-6935
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Provider Business Mailing Address
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Address Line | 4017 CROWN CT
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City | DENTON
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State | TX
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Zip | 76207-7590
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Country | US
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Telephone | 817-937-8896
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 75981
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 75981
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License Number State | TX
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