Provider Demographics
NPI:1659420461
Name:MCLAUGHLIN, VICKI ANN (LCPC, NCC, CRC, DCC)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:ANN
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:LCPC, NCC, CRC, DCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S OSPREY DR
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9795
Mailing Address - Country:US
Mailing Address - Phone:208-704-4097
Mailing Address - Fax:208-765-2558
Practice Address - Street 1:1620 NORTHWEST BLVD
Practice Address - Street 2:C-201
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2488
Practice Address - Country:US
Practice Address - Phone:208-704-4097
Practice Address - Fax:208-765-2558
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-2989101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health