Laura La Porte, LCSW

Individual provider Active NPI Clinical Social Worker · Glencoe, IL

NPI 1801444906 · NPPES record last updated Feb 20, 2024

Key facts

NPI
1801444906
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149.013233 (IL)
Practice address
991 Edgebrook LN
Glencoe, IL 60022-1043
Phone
(773) 580-2869
NPI assigned
Sep 1, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
149.013233ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP
1041C0700X 149.013233 IL Yes

Addresses

Primary practice location

991 Edgebrook LN
Glencoe, IL 60022-1043

Mailing address

991 Edgebrook LN
Glencoe, IL 60022-1043

Other providers in Glencoe, IL

All providers in Glencoe, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.