Provider Demographics
NPI:1730374869
Name:ACUNA, LAURA JO (LCSW-S)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JO
Last Name:ACUNA
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 S LAMAR BLVD # D109-231
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-8863
Mailing Address - Country:US
Mailing Address - Phone:512-632-3141
Mailing Address - Fax:
Practice Address - Street 1:2501 W WILLIAM CANNON DR STE A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5281
Practice Address - Country:US
Practice Address - Phone:512-344-9181
Practice Address - Fax:512-344-9135
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX252891041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3630493Medicaid