Provider Demographics
NPI:1093900490
Name:GROH, LAURIE YINKO (MS, LPC, SAS)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:YINKO
Last Name:GROH
Suffix:
Gender:F
Credentials:MS, LPC, SAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH BAY
Mailing Address - State:WI
Mailing Address - Zip Code:53211-1215
Mailing Address - Country:US
Mailing Address - Phone:262-227-5890
Mailing Address - Fax:
Practice Address - Street 1:10045 W LISBON AVE
Practice Address - Street 2:SUITE 221
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-2446
Practice Address - Country:US
Practice Address - Phone:414-358-7999
Practice Address - Fax:414-358-7158
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-09
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43724200Medicaid
WI42026400OtherNARCOTIC TREATMENT