Provider Demographics
NPI:1851035059
Name:RICHARDSON, LAURIE BETH (LMFT)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:BETH
Last Name:RICHARDSON
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 1:718 ALHAMBRA BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3825
Mailing Address - Country:US
Mailing Address - Phone:908-442-3396
Mailing Address - Fax:
Practice Address - Street 1:718 ALHAMBRA BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3825
Practice Address - Country:US
Practice Address - Phone:908-442-3396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-24
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132096106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist