Provider Demographics
NPI:1225890700
Name:LAINE, LAURIE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:LAINE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:LAINE
Other - Last Name:STEFFENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:7445 N ORACLE RD STE 155
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-6367
Mailing Address - Country:US
Mailing Address - Phone:520-791-9974
Mailing Address - Fax:
Practice Address - Street 1:7670 E BROADWAY BLVD STE 107
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3440
Practice Address - Country:US
Practice Address - Phone:520-791-9974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-22753101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor