Provider Demographics
NPI:1548870900
Name:JASTER, LAURA WADE (MA, NCC, ERYT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:WADE
Last Name:JASTER
Suffix:
Gender:F
Credentials:MA, NCC, ERYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4740 W 37TH AVE UNIT 26
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-2061
Mailing Address - Country:US
Mailing Address - Phone:720-334-7124
Mailing Address - Fax:
Practice Address - Street 1:750 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3394
Practice Address - Country:US
Practice Address - Phone:720-334-7124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0012351101YM0800X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No374J00000XNursing Service Related ProvidersDoula