Provider Demographics
NPI:1245484864
Name:MCDONNELL, LAURIE JO HARVEY (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LAURIE JO
Middle Name:HARVEY
Last Name:MCDONNELL
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 1:26843 TANIC DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4618
Mailing Address - Country:US
Mailing Address - Phone:813-326-5199
Mailing Address - Fax:
Practice Address - Street 1:26843 TANIC DR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4618
Practice Address - Country:US
Practice Address - Phone:813-326-5199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 2063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist