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General NPI Number Information
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NPI Number | 1821412602
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Entity Type | Organization
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Legal Business Name | LAURA LININGER, LCSW COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 09/03/2014
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Provider Practice Location Address
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Address Line | 101 W KIRKWOOD AVE FOUNTAIN SQUARE, SUITE 218
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City | BLOOMINGTON
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State | IN
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Zip | 47404-6129
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Country | US
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Telephone | 812-327-6842
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Fax | 812-676-9351
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Provider Business Mailing Address
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Address Line | 101 W KIRKWOOD AVE FOUNTAIN SQUARE, SUITE 218
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City | BLOOMINGTON
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State | IN
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Zip | 47404-6129
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Country | US
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Telephone | 812-327-6842
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Fax | 812-676-9351
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Authorized Official
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Title or Position | SOLE PROPRIETOR/ THERAPIST
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Name | MS. LAURA DIANE LININGER
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Credential | LCSW
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Telephone | 812-327-6842
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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 | 34003425A
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License Number State | IN
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