| Laura Willenborg Counseling Llc | |
|
1000 Sagamore Pkwy N Ste 207 Lafayette IN 47904-2474 | |
| (815) 343-2074 | |
| Not Available |
| Full Name | Laura Willenborg Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1000 Sagamore Pkwy N Ste 207, Lafayette, Indiana |
| Authorized Official Name and Position | Laura Willenborg (SOLE MBR) |
| Authorized Official Contact | 7654135835 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laura Willenborg Counseling Llc 1000 Sagamore Pkwy N Ste 207 Lafayette IN 47904-2474 Ph: (815) 343-2074 | Laura Willenborg Counseling Llc 1000 Sagamore Pkwy N Ste 207 Lafayette IN 47904-2474 Ph: (815) 343-2074 |
| NPI Number | 1861952210 |
|---|---|
| Provider Enumeration Date | 03/21/2019 |
| Last Update Date | 03/21/2019 |
| Medicare PECOS PAC ID | 4183966880 |
|---|---|
| Medicare Enrollment ID | O20190508001783 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861952210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Laura A Willenborg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528326485 PECOS PAC ID: 9436312246 Enrollment ID: I20120515000120 |
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