Provider Demographics
NPI:1023184082
Name:POOLER, LAURA CATHERINE (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:CATHERINE
Last Name:POOLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 ROSAL LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-2639
Mailing Address - Country:US
Mailing Address - Phone:925-408-2104
Mailing Address - Fax:
Practice Address - Street 1:2255 MORELLO AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94523-1824
Practice Address - Country:US
Practice Address - Phone:925-603-3108
Practice Address - Fax:925-265-2273
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 262631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical