Provider Demographics
NPI:1952627747
Name:LAUER, KIM ARLENE (MFT)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:ARLENE
Last Name:LAUER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1793
Mailing Address - Country:US
Mailing Address - Phone:818-907-1480
Mailing Address - Fax:818-907-1482
Practice Address - Street 1:5000 VAN NUYS BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1793
Practice Address - Country:US
Practice Address - Phone:818-907-1480
Practice Address - Fax:818-907-1482
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 31538106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist