Provider Demographics
NPI:1649748039
Name:WESSELMANN, LAURIE (LCPC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:WESSELMANN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 S LEMON AVE UNIT 9892
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2706
Mailing Address - Country:US
Mailing Address - Phone:800-318-3963
Mailing Address - Fax:800-318-3963
Practice Address - Street 1:600 S 2ND ST STE 404
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-2542
Practice Address - Country:US
Practice Address - Phone:800-318-3963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor