Basic Information
Provider Information
NPI: 1831483981
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAUER ROY
FirstName: ANNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 185 SUTTLE ST
Address2:  
City: DURANGO
State: CO
PostalCode: 813038276
CountryCode: US
TelephoneNumber: 9703352232
FaxNumber: 9703352438
Practice Location
Address1: 281 SAWYER DR STE 100
Address2:  
City: DURANGO
State: CO
PostalCode: 813033409
CountryCode: US
TelephoneNumber: 9702592162
FaxNumber: 9702475255
Other Information
ProviderEnumerationDate: 06/07/2011
LastUpdateDate: 02/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XLPC.0012235COY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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