Individual
LAURA BETH WEISMAN CLEAVLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
2453 ATWOOD AVE STE 103, MADISON, WI 53704-5655
(414) 803-2805
Mailing address
9 TERN CIR, MADISON, WI 53716-4403
(414) 803-2805
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5354-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12755282
CAQH
WI
05
—
6088247243
—
WI
01
—
LWEISMAN2835
ANTHEM BCBS WI
WI
Enumeration date
06/05/2014
Last updated
06/03/2016
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