Provider Demographics
NPI:1093745820
Name:DURANEY, LAURIE L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:L
Last Name:DURANEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LAURIE
Other - Middle Name:L
Other - Last Name:DURANEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1103 CONNIE RD
Mailing Address - Street 2:APT. 8
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-3215
Mailing Address - Country:US
Mailing Address - Phone:608-448-2097
Mailing Address - Fax:
Practice Address - Street 1:N6520 GUY RD
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-5405
Practice Address - Country:US
Practice Address - Phone:608-355-1240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI77418-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA644634Medicaid
PAIP160511Medicare UPIN
PA644634Medicaid