Provider Demographics
NPI:1982341715
Name:JOACHIM, LAURA ERIN (MA, LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ERIN
Last Name:JOACHIM
Suffix:
Gender:F
Credentials:MA, LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16430 SE MARNA RD
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:OR
Mailing Address - Zip Code:97089-8846
Mailing Address - Country:US
Mailing Address - Phone:360-224-6718
Mailing Address - Fax:
Practice Address - Street 1:123 E POWELL BLVD STE 303
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7620
Practice Address - Country:US
Practice Address - Phone:503-308-9140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR7545101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health