Provider Demographics
NPI:1326203555
Name:CADY, LAURA LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:CADY
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 1:4940 PEARLMAN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2788
Mailing Address - Country:US
Mailing Address - Phone:619-993-0477
Mailing Address - Fax:
Practice Address - Street 1:4940 PEARLMAN WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2788
Practice Address - Country:US
Practice Address - Phone:619-993-0477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS166681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical