MEDICARE: MRS. LAURA ANN LAMONT CAPSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	7477-123	WI

General Provider Information

NPI Number	:	1326286139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURA ANN LAMONT CAPSW, LCSW

Provider Business Mailing Address
First Line	:	2363 S 102ND ST STE 203
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53227-2143
Country	:	US
Telephone Number	:	262-648-6567
Fax Number	:

Provider Business Practice Location Address
First Line	:	2363 S 102ND ST STE 203
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53227-2143
Country	:	US
Telephone Number	:	262-648-6567
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2009
Last Update Date	:	04/28/2023

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