Individual provider Active NPI

Laurie Renne Lafollette

  • Mental Health Counselor
  • Martinsburg, WV
National Provider Identifier
1194448084
Registry record updated Sep 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC15392 Issued in MD
Practice address
510 Butler Ave
Martinsburg, WV 25405-9991
Phone
(304) 283-8752
NPI assigned
Sep 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3018 WV
Mental Health Counselor 101YM0800X LC15392 MD Primary

Addresses

Primary practice location

510 Butler Ave
Martinsburg, WV 25405-9991

Mailing address

246 Violet LN
Falling Waters, WV 25419-4174
Phone (304) 283-8752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC15392MDMDMental Health Counselor
3018WVMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725667200000",
    "number": "1194448084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 VIOLET LN",
            "city": "FALLING WATERS",
            "state": "WV",
            "postal_code": "254194174",
            "telephone_number": "304-283-8752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BUTLER AVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254059991",
            "telephone_number": "304-283-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFOLLETTE",
        "first_name": "LAURIE",
        "middle_name": "RENNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2024-09-07",
        "certification_date": "2024-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "3018",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC15392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2024; 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.