Provider Demographics
NPI:1164160941
Name:LAURITZEN, HAILEE FERN (DHSC, MSW, LSW)
Entity Type:Individual
Prefix:DR
First Name:HAILEE
Middle Name:FERN
Last Name:LAURITZEN
Suffix:
Gender:F
Credentials:DHSC, MSW, LSW
Other - Prefix:MS
Other - First Name:HAILEE
Other - Middle Name:FERN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6401 S US HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4749
Mailing Address - Country:US
Mailing Address - Phone:812-299-1156
Mailing Address - Fax:812-298-3109
Practice Address - Street 1:6401 S US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4749
Practice Address - Country:US
Practice Address - Phone:812-299-1156
Practice Address - Fax:812-298-3109
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker