Provider Demographics
NPI:1841538634
Name:GOLDEY, LAURIE MICHELE (MS, LMFT)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:MICHELE
Last Name:GOLDEY
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3821 PARKVIEW CT
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-3512
Mailing Address - Country:US
Mailing Address - Phone:818-825-1647
Mailing Address - Fax:
Practice Address - Street 1:15300 VENTURA BLVD
Practice Address - Street 2:SUITE 324
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3103
Practice Address - Country:US
Practice Address - Phone:818-825-1647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52388106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist