Provider Demographics
NPI:1932351160
Name:PROROK, LALITA LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:LALITA
Middle Name:LYNN
Last Name:PROROK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LALITA
Other - Middle Name:LYNN
Other - Last Name:FORTUNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 N DEWEY ST
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-3218
Mailing Address - Country:US
Mailing Address - Phone:715-834-6681
Mailing Address - Fax:715-834-9954
Practice Address - Street 1:550 N DEWEY ST
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-3218
Practice Address - Country:US
Practice Address - Phone:715-834-6681
Practice Address - Fax:715-834-9954
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4104-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional