Provider Demographics
NPI:1225411523
Name:CHANDLER, LAUREN (LMFT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 BUENA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1503
Mailing Address - Country:US
Mailing Address - Phone:415-562-7768
Mailing Address - Fax:
Practice Address - Street 1:119 WARD ST
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1326
Practice Address - Country:US
Practice Address - Phone:415-562-7768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-04
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86949106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist