Provider Demographics
NPI:1417274101
Name:GRONEMEIER, LAUREY (MED, LPC, NCC, MAC)
Entity type:Individual
Prefix:
First Name:LAUREY
Middle Name:
Last Name:GRONEMEIER
Suffix:
Gender:F
Credentials:MED, LPC, NCC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10998
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99710-0998
Mailing Address - Country:US
Mailing Address - Phone:907-322-0293
Mailing Address - Fax:833-368-6338
Practice Address - Street 1:1340 GULL RD
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99712-1223
Practice Address - Country:US
Practice Address - Phone:907-322-0293
Practice Address - Fax:833-368-6338
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-8101101YP2500X
AKPCOP797101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional