Provider Demographics
NPI:1043416530
Name:CELNAR, LAURA ANN CHRISTOFFERSON (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN CHRISTOFFERSON
Last Name:CELNAR
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 1:5815 ELDERGARDENS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-3727
Mailing Address - Country:US
Mailing Address - Phone:619-358-4936
Mailing Address - Fax:
Practice Address - Street 1:7465 MISSION GORGE RD STE 157
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-1301
Practice Address - Country:US
Practice Address - Phone:619-218-5002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS265761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical