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General NPI Number Information
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NPI Number | 1831781566
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Entity Type | Organization
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Legal Business Name | LAURE R GARGANO LLC
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 115 FARLEY CIR STE 303
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City | LEWISBURG
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State | PA
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Zip | 17837-9252
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Country | US
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Telephone | 570-490-3028
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Fax | 800-856-8690
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Provider Business Mailing Address
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Address Line | 1012 MCRAE LN
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City | LEWISBURG
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State | PA
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Zip | 17837-6624
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Country | US
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Telephone | 157-049-0302
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | LAURE ROHRS GARGANO
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Credential | LCSW
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Telephone | 570-490-3028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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