Provider Demographics
NPI:1699033555
Name:MEARSE, LAURIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:
Last Name:MEARSE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:LAURIE
Other - Middle Name:MEARSE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 4834
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90231
Mailing Address - Country:US
Mailing Address - Phone:323-294-3294
Mailing Address - Fax:
Practice Address - Street 1:11835 WEST OLYMPIC BLVD
Practice Address - Street 2:SUITE 1090
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064
Practice Address - Country:US
Practice Address - Phone:323-294-3294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker