Provider Demographics
NPI:1659442259
Name:PASCH, LAURIE BERG (MSSW LCSW LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:BERG
Last Name:PASCH
Suffix:
Gender:F
Credentials:MSSW LCSW LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7627 N LINKS WAY
Mailing Address - Street 2:
Mailing Address - City:FOX POINT
Mailing Address - State:WI
Mailing Address - Zip Code:53217
Mailing Address - Country:US
Mailing Address - Phone:414-351-5985
Mailing Address - Fax:
Practice Address - Street 1:10303 N PT WASHINGTON ROAD
Practice Address - Street 2:SUITE #208
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092
Practice Address - Country:US
Practice Address - Phone:262-241-5955
Practice Address - Fax:262-241-5926
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3601241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical