Provider Demographics
NPI:1053575696
Name:BRODIE, LAURA BETH (MA, ATR, LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:BRODIE
Suffix:
Gender:F
Credentials:MA, ATR, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 LARIMER ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1610
Mailing Address - Country:US
Mailing Address - Phone:303-981-8508
Mailing Address - Fax:
Practice Address - Street 1:1512 LARIMER ST
Practice Address - Street 2:SUITE 410
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1610
Practice Address - Country:US
Practice Address - Phone:303-981-8508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO879101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional