Provider Demographics
NPI:1538555107
Name:RAICHLE, LAURA ELIZABETH (MSW, LCSWA)
Entity type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:ELIZABETH
Last Name:RAICHLE
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 WEBSTER PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2334
Mailing Address - Country:US
Mailing Address - Phone:704-770-6551
Mailing Address - Fax:
Practice Address - Street 1:425 WEBSTER PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2334
Practice Address - Country:US
Practice Address - Phone:704-770-6551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-10
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical