Provider Demographics
NPI:1356468268
Name:EDMOND, LAURIE L (LCSW-C)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:L
Last Name:EDMOND
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3463 HEWITT AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5444
Mailing Address - Country:US
Mailing Address - Phone:301-463-5472
Mailing Address - Fax:
Practice Address - Street 1:1301 PICCARD DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4320
Practice Address - Country:US
Practice Address - Phone:240-777-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13259104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker