Provider Demographics
NPI:1992176234
Name:TOWNSEND, LAURA ANN (MA, LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:TOWNSEND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1403 4TH ST
Mailing Address - Street 2:
Mailing Address - City:KEWAUNEE
Mailing Address - State:WI
Mailing Address - Zip Code:54216-1678
Mailing Address - Country:US
Mailing Address - Phone:920-495-0442
Mailing Address - Fax:
Practice Address - Street 1:3120 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-3229
Practice Address - Country:US
Practice Address - Phone:920-657-1780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2735-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional