Provider Demographics
NPI:1265631154
Name:HAUGAARD, LAURA N (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:N
Last Name:HAUGAARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:
Other - Last Name:HAUGAARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:5815 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-3123
Mailing Address - Country:US
Mailing Address - Phone:620-792-2544
Mailing Address - Fax:620-792-7052
Practice Address - Street 1:5815 BROADWAY
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-3123
Practice Address - Country:US
Practice Address - Phone:620-792-2544
Practice Address - Fax:620-792-7052
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS880101YP2500X
KS23111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200879420AMedicaid