Provider Demographics
NPI:1144757394
Name:RECHEK, LAURIE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:RECHEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:ANN
Other - Last Name:BUSSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:845 PARKSIDE ST
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:WI
Mailing Address - Zip Code:54971-8505
Mailing Address - Country:US
Mailing Address - Phone:920-926-4200
Mailing Address - Fax:920-926-8914
Practice Address - Street 1:845 PARKSIDE ST
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:WI
Practice Address - Zip Code:54971-8505
Practice Address - Country:US
Practice Address - Phone:920-926-4200
Practice Address - Fax:920-926-8914
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9332-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical