Provider Demographics
NPI:1962549568
Name:STRUNK, LAURA LYNN (MSSW, LICSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:STRUNK
Suffix:
Gender:F
Credentials:MSSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 CENTER ST
Mailing Address - Street 2:PO BOX 788
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-3255
Mailing Address - Country:US
Mailing Address - Phone:507-359-6569
Mailing Address - Fax:
Practice Address - Street 1:1117 CENTER ST
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-3255
Practice Address - Country:US
Practice Address - Phone:507-359-6569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN62-52262OtherUBH