Provider Demographics
NPI:1164610556
Name:HALONEN, LAURA CAROLYNE (LPC LICENSE PROFESSI)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:CAROLYNE
Last Name:HALONEN
Suffix:
Gender:F
Credentials:LPC LICENSE PROFESSI
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:CAROLYNE
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11615 STATE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-1797
Mailing Address - Country:US
Mailing Address - Phone:218-855-5074
Mailing Address - Fax:
Practice Address - Street 1:11615 STATE AVENUE
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-1797
Practice Address - Country:US
Practice Address - Phone:218-855-5074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00253101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional