Provider Demographics
NPI:1861796310
Name:UNGER, LAURIE LYNN (LPC)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:LYNN
Last Name:UNGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21714 HARDY OAK
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4838
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21714 HARDY OAK
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4838
Practice Address - Country:US
Practice Address - Phone:210-772-6367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-26
Last Update Date:2010-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66031101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional