Laura Coulthard

Individual provider Active NPI Clinical Social Worker · Darlington, WI

NPI 1124344155 · NPPES record last updated Apr 15, 2010

Key facts

NPI
1124344155
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
627 Main St
Darlington, WI 53530-1395
Phone
(608) 776-4800
Fax
(608) 776-4914
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

627 Main St
Darlington, WI 53530-1395

Mailing address

627 Main St
Darlington, WI 53530-1395
Phone (608) 776-4800

Other identifiers

IdentifierTypeStateIssuer
42139000MedicaidWI

Other providers in Darlington, WI

All providers in Darlington, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.