Provider Demographics
NPI:1093159881
Name:BLANCHARD, LAUREANN (LPC)
Entity Type:Individual
Prefix:
First Name:LAUREANN
Middle Name:
Last Name:BLANCHARD
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 1:214 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-2719
Mailing Address - Country:US
Mailing Address - Phone:715-203-3971
Mailing Address - Fax:
Practice Address - Street 1:1000 N OAK AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-5703
Practice Address - Country:US
Practice Address - Phone:715-221-5766
Practice Address - Fax:715-221-5715
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6014101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1721-226OtherSTATE LICENSE - PROFESSIONAL COUNSELOR TRAINING LICENSE