Provider Demographics
NPI:1043683972
Name:LAURA A. RAHN, LLC
Entity Type:Organization
Organization Name:LAURA A. RAHN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAHN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:414-732-7187
Mailing Address - Street 1:S16W32615 LUTERBACH CT
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-3368
Mailing Address - Country:US
Mailing Address - Phone:414-732-7187
Mailing Address - Fax:
Practice Address - Street 1:3215 GOLF RD
Practice Address - Street 2:STE 173
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2157
Practice Address - Country:US
Practice Address - Phone:414-732-7187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7372-123251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1477733848OtherNPI-INDIVIDUAL
WI43719900Medicaid