Provider Demographics
NPI:1639247505
Name:HAUSER, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HAUSER
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 1:59 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8800
Mailing Address - Country:US
Mailing Address - Phone:207-590-1573
Mailing Address - Fax:207-396-5149
Practice Address - Street 1:605 US ROUTE 1 STE 16
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9617
Practice Address - Country:US
Practice Address - Phone:207-590-1573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME315226101YA0400X
MEME2547901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)