Provider Demographics
NPI:1306207949
Name:LAING, ELYSE MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:ELYSE
Middle Name:MARIE
Last Name:LAING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:ELYSE
Other - Middle Name:MARIE
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:6482 STATE ROAD 19
Mailing Address - Street 2:
Mailing Address - City:WAUNAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53597
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:COMMON THREADS
Practice Address - Street 2:5979 SIGGELKOW RD.
Practice Address - City:MCFARLAND
Practice Address - State:WI
Practice Address - Zip Code:53558
Practice Address - Country:US
Practice Address - Phone:608-838-8999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional