Provider Demographics
NPI:1205034436
Name:PERSH, LAURIE A (LCPC,LPC, CCMHC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:PERSH
Suffix:
Gender:F
Credentials:LCPC,LPC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MONTVALE TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1223
Mailing Address - Country:US
Mailing Address - Phone:443-622-3633
Mailing Address - Fax:301-879-4560
Practice Address - Street 1:208 MONTVALE TER
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1223
Practice Address - Country:US
Practice Address - Phone:301-887-3644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC13708101YP2500X
VA0701005011101YP2500X
DCLMFT000113106H00000X
MDLC0527101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist