Provider Demographics
NPI:1447887419
Name:REIN, LAURIE (LMFT)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:REIN
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 1:25514 HEMINGWAY AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381-1574
Mailing Address - Country:US
Mailing Address - Phone:310-489-8218
Mailing Address - Fax:
Practice Address - Street 1:25514 HEMINGWAY AVE UNIT B
Practice Address - Street 2:
Practice Address - City:STEVENSON RANCH
Practice Address - State:CA
Practice Address - Zip Code:91381-1574
Practice Address - Country:US
Practice Address - Phone:310-489-8218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT28043106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist