Individual
LAURA M FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
4001 JOHN ST, EVANSVILLE, IN 47714-0216
(812) 473-3144
(812) 422-7558
Mailing address
415 MULBERRY ST, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007154A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000918846
ANTHEM
—
01
—
12791110
CAQH
—
01
—
170768
SIHO
—
Enumeration date
01/31/2012
Last updated
10/09/2015
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