Provider Demographics
NPI:1730697400
Name:MCLEAN, LAURIE (LMFT)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:STERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2716 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-2671
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:877-512-9251
Practice Address - Street 1:2716 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-2671
Practice Address - Country:US
Practice Address - Phone:310-200-9309
Practice Address - Fax:877-512-9251
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44518106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist