Provider Demographics
NPI:1811318660
Name:O'CONNELL, LAUREN JOY (LMFT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JOY
Last Name:O'CONNELL
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 1:1150 YALE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4738
Mailing Address - Country:US
Mailing Address - Phone:424-274-1930
Mailing Address - Fax:
Practice Address - Street 1:1150 YALE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4738
Practice Address - Country:US
Practice Address - Phone:424-274-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77515106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist