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NPI 1780988733

NPI 1780988733 : CATALINA LAURENZANO M.A, LCPC : WOODSTOCK, GA

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General NPI Number Information
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    NPI Number           |    1780988733
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    Entity Type          |    Individual 
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    Provider Name        |    CATALINA LAURENZANO M.A, LCPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/05/2011
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    Last Update Date     |    07/16/2015
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Provider Practice Location Address
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    Address Line         |    409 OLD BORING LN 
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    City                 |    WOODSTOCK
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    State                |    GA
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    Zip                  |    30189-2495
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    Country              |    US
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    Telephone            |    770-928-7618
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    238 COLONIAL DR 
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    City                 |    WOODSTOCK
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    State                |    GA
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    Zip                  |    30189-6135
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    Country              |    US
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    Telephone            |    240-370-9178
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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       |    LC3784
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    LPC008341
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    License Number State |    GA
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