Provider Demographics
NPI:1083865307
Name:FINSTROM, LAURIE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:
Last Name:FINSTROM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10708 BLUEWATER PSGE
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-9083
Mailing Address - Country:US
Mailing Address - Phone:479-238-3878
Mailing Address - Fax:
Practice Address - Street 1:3102 SE J ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3796
Practice Address - Country:US
Practice Address - Phone:479-238-3878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA0509067101YM0800X
ARP0712068101YM0800X
ARA060809106H00000X
ARMO712006106H00000X
ARPO712068101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist