MEDICARE: LAURIE BETH TROUMBLY MS, LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	101YM0800X	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578080875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE BETH TROUMBLY MS, LPCC

Provider Business Mailing Address
First Line	:	813 S POKEGAMA AVE STE B
Second Line	:
City	:	GRAND RAPIDS
State	:	MN
Zip	:	55744-3934
Country	:	US
Telephone Number	:	218-999-9432
Fax Number	:

Provider Business Practice Location Address
First Line	:	813 S POKEGAMA AVE STE B
Second Line	:
City	:	GRAND RAPIDS
State	:	MN
Zip	:	55744-3934
Country	:	US
Telephone Number	:	218-999-9432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2017
Last Update Date	:	09/05/2019

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