Healthcare Provider Details

I. General information

NPI: 1407750904
Provider Name (Legal Business Name): LAURA RONCK THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3462 GLACIER RIDGE RD
MIDDLETON WI
53562-1860
US

IV. Provider business mailing address

3462 GLACIER RIDGE RD
MIDDLETON WI
53562-1860
US

V. Phone/Fax

Practice location:
  • Phone: 608-420-3131
  • Fax:
Mailing address:
  • Phone: 608-420-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAURA RONCK
Title or Position: OWNER
Credential: LPC
Phone: 608-420-3131