Provider Demographics
NPI:1558454793
Name:FOLEY, LAWRENCE WILLIAM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:WILLIAM
Last Name:FOLEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-2016
Mailing Address - Country:US
Mailing Address - Phone:651-214-6506
Mailing Address - Fax:651-483-0341
Practice Address - Street 1:521 TANGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-2016
Practice Address - Country:US
Practice Address - Phone:651-214-6506
Practice Address - Fax:651-483-0341
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3415103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical