Provider Demographics
NPI:1013949759
Name:CHOINIERE, G. LAURENT (NP, PHD, LPC)
Entity Type:Individual
Prefix:
First Name:G.
Middle Name:LAURENT
Last Name:CHOINIERE
Suffix:
Gender:M
Credentials:NP, PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 601843
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3163 GAMMON LN
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-9052
Practice Address - Country:US
Practice Address - Phone:336-310-5571
Practice Address - Fax:336-310-5574
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC661101Y00000X
NC5005702363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily