MEDICARE: DR. LAURA MANUPPELLI PHD LMFT LPC

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	101YP2500X	Professional Counselor	LPC 11199	TX
2	106H00000X	Marriage & Family Therapist	LMFT 2749	TX

General Provider Information

NPI Number	:	1356497051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA MANUPPELLI PHD LMFT LPC

Provider Business Mailing Address
First Line	:	4901 BROADWAY
Second Line	:	SUITE 152
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209
Country	:	US
Telephone Number	:	210-824-6884
Fax Number	:	210-826-7882

Provider Business Practice Location Address
First Line	:	4901 BROADWAY
Second Line	:	SUITE 152
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209
Country	:	US
Telephone Number	:	210-824-6884
Fax Number	:	210-826-7882

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	09/11/2025

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