Provider Demographics
NPI:1174981377
Name:AHLSTROM, LAURA (LMFT-I)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:AHLSTROM
Suffix:
Gender:F
Credentials:LMFT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NV
Mailing Address - Zip Code:89415-1554
Mailing Address - Country:US
Mailing Address - Phone:702-483-0826
Mailing Address - Fax:
Practice Address - Street 1:112 W 5TH ST
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NV
Practice Address - Zip Code:89415-7708
Practice Address - Country:US
Practice Address - Phone:702-483-0826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4978106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist