Provider Demographics
NPI:1538156617
Name:LAUREL, CYD L (MA, LPCC)
Entity type:Individual
Prefix:MRS
First Name:CYD
Middle Name:L
Last Name:LAUREL
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 REYNOLDS RD STE 215
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1634
Mailing Address - Country:US
Mailing Address - Phone:419-283-6958
Mailing Address - Fax:
Practice Address - Street 1:1446 REYNOLDS RD STE 215
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1634
Practice Address - Country:US
Practice Address - Phone:419-885-1910
Practice Address - Fax:419-885-5060
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0003324-S101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health