Laura S Medlin, M.A.

Individual provider Active NPI Marriage & Family Therapist · Elburn, IL

NPI 1306130067 · NPPES record last updated May 30, 2011

Key facts

NPI
1306130067
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
208000209 (IL)
Practice address
106 W Pierce St
Elburn, IL 60119-8201
Phone
(630) 365-0899
NPI assigned
May 30, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
208000209ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Rural Psychology Past Accepting new patients
Foroutan & Associates SC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 208000209 IL Yes

Addresses

Primary practice location

106 W Pierce St
Elburn, IL 60119-8201

Mailing address

106 W Pierce St
Elburn, IL 60119-8201

Other providers in Elburn, IL

All providers in Elburn, IL · Marriage & Family Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.