Provider Demographics
NPI:1720815137
Name:STOESZ, LAURA JANEL (LPC IT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JANEL
Last Name:STOESZ
Suffix:
Gender:U
Credentials:LPC IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 N SHERMAN AVE STE 24
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-4457
Mailing Address - Country:US
Mailing Address - Phone:608-445-2510
Mailing Address - Fax:
Practice Address - Street 1:615 N SHERMAN AVE STE 24
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-4457
Practice Address - Country:US
Practice Address - Phone:608-445-2510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8047226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health