Provider Demographics
NPI:1245767805
Name:BOERMAN, LAURIE LEA (LPC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:LEA
Last Name:BOERMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 LAKEVIEW PKWY STE 700
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-9066
Mailing Address - Country:US
Mailing Address - Phone:470-253-0950
Mailing Address - Fax:678-916-3810
Practice Address - Street 1:2300 LAKEVIEW PKWY STE 700
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-9066
Practice Address - Country:US
Practice Address - Phone:470-253-0950
Practice Address - Fax:678-916-3810
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009428101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional