Provider Demographics
NPI:1497403497
Name:GRAND, LAURIE COPE (MS LMFT)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:COPE
Last Name:GRAND
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 TREEHOUSE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-0691
Mailing Address - Country:US
Mailing Address - Phone:650-235-5230
Mailing Address - Fax:
Practice Address - Street 1:102 TREEHOUSE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92603-0691
Practice Address - Country:US
Practice Address - Phone:650-235-5230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health