Provider Demographics
NPI:1205951571
Name:WILLIAMS, LAURIE MONIQUE (MFT, MS)
Entity type:Individual
Prefix:MISS
First Name:LAURIE
Middle Name:MONIQUE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MFT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19701 HAMILTON AVE STE 160
Mailing Address - Street 2:COUNSELING 4 KIDS
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1313
Mailing Address - Country:US
Mailing Address - Phone:323-365-5379
Mailing Address - Fax:
Practice Address - Street 1:19701 HAMILTON AVE STE 160
Practice Address - Street 2:COUNSELING 4 KIDS
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1313
Practice Address - Country:US
Practice Address - Phone:323-365-5379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40275106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist