Provider Demographics
NPI:1487142006
Name:KEMPNICH, LAURA (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:KEMPNICH
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:BOOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:515 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PARK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56470-1210
Mailing Address - Country:US
Mailing Address - Phone:218-366-9229
Mailing Address - Fax:218-237-2520
Practice Address - Street 1:515 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PARK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56470-1210
Practice Address - Country:US
Practice Address - Phone:218-366-9229
Practice Address - Fax:218-237-2520
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26986101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health