Provider Demographics
NPI:1770038747
Name:KARAN, LAURA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MARIE
Last Name:KARAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:MARIE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:5650 N GREEN BAY AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-4446
Mailing Address - Country:US
Mailing Address - Phone:262-789-1191
Mailing Address - Fax:414-921-5652
Practice Address - Street 1:5650 N GREEN BAY AVE STE 205
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-4446
Practice Address - Country:US
Practice Address - Phone:262-789-1191
Practice Address - Fax:414-921-5652
Is Sole Proprietor?:No
Enumeration Date:2016-08-19
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3180101Y00000X
WI4140-57103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor