MEDICARE: SUSAN MARIE LAUWERS

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	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000009153	OTHER	CA	UPIN

General Provider Information

NPI Number	:	1528217478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MARIE LAUWERS

Provider Business Mailing Address
First Line	:	1356 DANIELSON RD
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93108-2857
Country	:	US
Telephone Number	:	805-895-2655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 LAS CANOAS RD
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-2347
Country	:	US
Telephone Number	:	805-895-2655
Fax Number	:

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

Provider Enumeration Date	:	09/16/2008
Last Update Date	:	03/20/2014

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