Healthcare Provider Details

I. General information

NPI: 1902115876
Provider Name (Legal Business Name): LAURIE CATHERINE PELS-ROULIER M.S., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2010
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 E CENTER ST
MANCHESTER CT
06040-5245
US

IV. Provider business mailing address

29 JOEL DR
HEBRON CT
06248-1245
US

V. Phone/Fax

Practice location:
  • Phone: 860-942-6390
  • Fax:
Mailing address:
  • Phone: 860-729-3110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number001280
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: