Provider Demographics
NPI:1528323565
Name:LAUESEN, LUANN R
Entity type:Individual
Prefix:
First Name:LUANN
Middle Name:R
Last Name:LAUESEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 1ST AVE STE 300
Mailing Address - Street 2:TANANA CHIEFS CONFERENCE (SENIOR SERVICES)
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4848
Mailing Address - Country:US
Mailing Address - Phone:907-452-8251
Mailing Address - Fax:907-459-3985
Practice Address - Street 1:201 1ST AVE STE 300
Practice Address - Street 2:TANANA CHIEFS CONFERENCE (SENIOR SERVICES)
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4848
Practice Address - Country:US
Practice Address - Phone:907-452-8251
Practice Address - Fax:907-459-3985
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMH0157Medicaid
AKMH0157Medicaid