Provider Demographics
NPI:1730402660
Name:MORRISON, LAUREL BALYEAT (MA,MARR & FAMTHER)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:BALYEAT
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MA,MARR & FAMTHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6049 FELIX AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-1218
Mailing Address - Country:US
Mailing Address - Phone:510-323-4737
Mailing Address - Fax:510-323-4737
Practice Address - Street 1:3118 SHANE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-2627
Practice Address - Country:US
Practice Address - Phone:510-323-4737
Practice Address - Fax:510-323-4737
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-06
Last Update Date:2010-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT17966106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist