Provider Demographics
NPI:1649558164
Name:BORGMEYER, LAURI (LMHC)
Entity Type:Individual
Prefix:
First Name:LAURI
Middle Name:
Last Name:BORGMEYER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11802 NE 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-1560
Mailing Address - Country:US
Mailing Address - Phone:360-891-2000
Mailing Address - Fax:360-944-6965
Practice Address - Street 1:11802 NE 117TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-1560
Practice Address - Country:US
Practice Address - Phone:360-891-2000
Practice Address - Fax:360-944-6965
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005630101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health