Laura Weatherby PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

LAURA WEATHERBY PLLC

Doing business as

Glacial Lakes Therapy

Practice address

800 E Depue Ave Ste B
Olivia, MN 56277-1388

Phone

(000) 000-0000

NPI assigned

Jul 11, 2022

Last updated

Jul 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Laura Beth Weatherby, LPNPI 1770664781

Title

Licensed Psychologist

Phone

(320) 220-4046

Specialties & licenses 1

Addresses

Other names 1

• Glacial Lakes Therapy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Laura Beth Weatherby, PSYD

  • Registered Nurse
  • Willmar, MN
  • NPI 1770664781
  NPD (past) Authorized official

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1982338448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 KANDIYOHI AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562012956",
            "telephone_number": "320-220-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DEPUE AVE STE B",
            "city": "OLIVIA",
            "state": "MN",
            "postal_code": "562771388",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA WEATHERBY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "WEATHERBY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "320-220-4046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glacial Lakes Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Elizabeth Johansen, FNP
• Kandiyohi-Renville Community Health Board
• Jon R Kemp, MD
• Roberta Lynn Kopel, DVM
• Jeffrey T Krogstad, MD
• Benjamin August Linder, MD
• Gary Lohmeyer, R.PH.
• Valarie Longhin
• Danelle Loomis
• Jason Chigoro Lee Mabee

• Psychologist in Olivia, MN
• Providers in Olivia, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.