Provider Demographics
NPI:1720126444
Name:UGLOW, LAWRENCE F (LPC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:F
Last Name:UGLOW
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 N PORT WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-5585
Mailing Address - Country:US
Mailing Address - Phone:262-240-0427
Mailing Address - Fax:262-240-0429
Practice Address - Street 1:10500 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5585
Practice Address - Country:US
Practice Address - Phone:262-240-0427
Practice Address - Fax:262-240-0429
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2655-125103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy