Laura Kathleen Iandoli, LCSW

Individual provider Active NPI Clinical Social Worker · Moody Afb, GA

NPI 1447736459 · NPPES record last updated Aug 1, 2023

Key facts

NPI: 1447736459
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: CSW007045 (GA)
Practice address: 3278 Mitchell Blvd
Moody Afb, GA 31699-1007
Phone: (229) 257-3898
NPI assigned: Jul 12, 2018
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Behavioral Health Crisis Center Mental Health Clinic/Center (Including Community Mental Health Center) · Valdosta, GA · NPI 1518396548

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Behavioral Health Crisis Center		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	CSW007045	GA	Yes

Addresses

Primary practice location

3278 Mitchell Blvd
Moody Afb, GA 31699-1007

Mailing address

3278 Mitchell Blvd
Moody Afb, GA 31699-1500

Other providers in Moody Afb, GA

All providers in Moody Afb, GA · Clinical Social Worker in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.