Provider Demographics
NPI:1578039202
Name:HURAND, ELISSA BETH (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:ELISSA
Middle Name:BETH
Last Name:HURAND
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21046 WAVEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TOPANGA
Mailing Address - State:CA
Mailing Address - Zip Code:90290-3553
Mailing Address - Country:US
Mailing Address - Phone:619-993-8465
Mailing Address - Fax:
Practice Address - Street 1:429 SANTA MONICA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-3408
Practice Address - Country:US
Practice Address - Phone:619-993-8465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-20
Last Update Date:2018-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2872101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health