Provider Demographics
NPI:1144038480
Name:VOLLAN, LAURIE (MSW, LICSW, SSW)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:
Last Name:VOLLAN
Suffix:
Gender:F
Credentials:MSW, LICSW, SSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3510
Mailing Address - Country:US
Mailing Address - Phone:320-905-0217
Mailing Address - Fax:651-431-7362
Practice Address - Street 1:1004 1ST ST S
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3510
Practice Address - Country:US
Practice Address - Phone:320-905-0217
Practice Address - Fax:651-431-7362
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4963981041S0200X
MN252741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool