Basic Information
| Provider Information | |||||||||
| NPI: | 1205115060 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELANEY | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | SEIDEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1239 C ST SE | ||||||||
| Address2: | APT 1 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200032234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018076285 | ||||||||
| FaxNumber: | 2026982466 | ||||||||
| Practice Location | |||||||||
| Address1: | 64 NEW YORK AVE NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200023320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2026982431 | ||||||||
| FaxNumber: | 2026982466 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2011 | ||||||||
| LastUpdateDate: | 06/14/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LC50078974 | DC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.