Provider Demographics
NPI:1003016627
Name:LURA, VALARIE JO (LCPC)
Entity Type:Individual
Prefix:MS
First Name:VALARIE
Middle Name:JO
Last Name:LURA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N3251 QUEEN RD
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-3330
Mailing Address - Country:US
Mailing Address - Phone:262-248-0626
Mailing Address - Fax:
Practice Address - Street 1:N3251 QUEEN RD
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-3330
Practice Address - Country:US
Practice Address - Phone:262-248-0626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-22
Last Update Date:2007-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional