Provider Demographics
NPI:1346813953
Name:GODLOVE, LAUREN ELISE (LMFT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELISE
Last Name:GODLOVE
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 1:4622 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-3051
Mailing Address - Country:US
Mailing Address - Phone:714-814-3182
Mailing Address - Fax:
Practice Address - Street 1:3233 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5817
Practice Address - Country:US
Practice Address - Phone:714-947-3246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141305106H00000X
CAAMFT12524106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist