Provider Demographics
NPI:1093866774
Name:LAUER, LINNEA CHRISTINE (MA, MED)
Entity Type:Individual
Prefix:MRS
First Name:LINNEA
Middle Name:CHRISTINE
Last Name:LAUER
Suffix:
Gender:F
Credentials:MA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:LIBERTY BAY COUNSELING SERVICES
Mailing Address - Street 2:20307 VIKING AVE., SUITE 203
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370
Mailing Address - Country:US
Mailing Address - Phone:360-697-1445
Mailing Address - Fax:360-697-5343
Practice Address - Street 1:LIBERTY BAY COUNSELING SERVICES
Practice Address - Street 2:20307 VIKING AVE. SUITE 203
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370
Practice Address - Country:US
Practice Address - Phone:360-697-1445
Practice Address - Fax:360-697-5343
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005365101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00005365OtherLICENSED MENTAL HEALTH CO