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General NPI Number Information
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NPI Number | 1962790857
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Entity Type | Individual
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Provider Name | LAURA M STURDEVANT LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 101 S OSCEOLA AVE STE 2
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City | INVERNESS
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State | FL
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Zip | 34452-4727
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Country | US
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Telephone | 352-322-2550
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 246
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City | HOMOSASSA SPRINGS
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State | FL
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Zip | 34447-0246
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Country | US
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Telephone | 352-322-2550
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 082257
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License Number State | NY
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Taxonomy #2
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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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