Active NPI
Laura Mennecke, LCPC
- Mental Health Counselor
- Severna Park, MD
National Provider Identifier
1477082873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC6877
- Practice address
- 479 Jumpers Hole Road
Suite 304B
Severna Park, MD 21146 - Phone
- (410) 693-7171
- NPI assigned
- Jun 8, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC6877 | MD | Primary |
Addresses
Primary practice location
479 Jumpers Hole Road
Suite 304B
Severna Park, MD 21146
Mailing address
479 Jumpers Hole Rd Ste 304B
Severna Park, MD 21146-1732
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC6877 | MD | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496880000000",
"number": "1477082873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "479 JUMPERS HOLE RD STE 304B",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211461732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "479 JUMPERS HOLE ROAD",
"address_2": "SUITE 304B",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "21146",
"telephone_number": "410-693-7171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENNECKE",
"first_name": "LAURA",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-08",
"last_updated": "2017-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "LPC6877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severna Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.