Provider Demographics
NPI:1538971973
Name:STRAUSBURG-SMITH, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:STRAUSBURG-SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 W 400 N
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47371-7975
Mailing Address - Country:US
Mailing Address - Phone:260-251-0494
Mailing Address - Fax:
Practice Address - Street 1:101 S MERIDIAN ST STE 201
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:IN
Practice Address - Zip Code:47371-2112
Practice Address - Country:US
Practice Address - Phone:260-251-6928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99123523A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker