Kaitlyn Laurie, S.C

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1915125 Issued in WI

Legal business name

KAITLYN LAURIE, S.C

Practice address

6320 Monona Dr
Monona, WI 53716-3952

Phone

(608) 235-3546

NPI assigned

Apr 17, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Kaitlyn Laurie, LPC

Title

Owner

Phone

(605) 235-3546

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302998400000",
    "number": "1033409677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 MONONA DR",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163952",
            "telephone_number": "608-235-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 MONONA DR",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163952",
            "telephone_number": "608-235-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAITLYN LAURIE, S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-17",
        "last_updated": "2011-04-17",
        "status": "A",
        "authorized_official_last_name": "LAURIE",
        "authorized_official_first_name": "KAITLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-235-3546",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1915125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42221000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.