Provider Demographics
NPI:1649282187
Name:BURMEISTER, LAURI (LPA)
Entity type:Individual
Prefix:
First Name:LAURI
Middle Name:
Last Name:BURMEISTER
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 STONE RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-8313
Mailing Address - Country:US
Mailing Address - Phone:828-242-3059
Mailing Address - Fax:828-645-0138
Practice Address - Street 1:303 STONE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-8313
Practice Address - Country:US
Practice Address - Phone:828-242-3059
Practice Address - Fax:828-645-0138
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2304103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107426Medicaid