Provider Demographics
NPI:1699239673
Name:RAJALA, LAURA D (LPC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:D
Last Name:RAJALA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 RAYOVAC DR.
Mailing Address - Street 2:#103
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2479
Mailing Address - Country:US
Mailing Address - Phone:608-238-5826
Mailing Address - Fax:608-238-1221
Practice Address - Street 1:700 RAYOVAC DR.
Practice Address - Street 2:#103
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2479
Practice Address - Country:US
Practice Address - Phone:608-238-5826
Practice Address - Fax:608-238-1221
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4240-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1699239673Medicaid