MEDICARE: MS. LAURA BARONE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW120782	CA
2	101YM0800X	Mental Health Counselor	91594	CA

General Provider Information

NPI Number	:	1730718917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA BARONE LCSW

Provider Business Mailing Address
First Line	:	313 GRAND BLVD
Second Line	:	PO BOX 1222
City	:	VENICE
State	:	CA
Zip	:	90291-2306
Country	:	US
Telephone Number	:	917-494-6287
Fax Number	:

Provider Business Practice Location Address
First Line	:	1107 OCEAN PARK BLVD APT B
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-4793
Country	:	US
Telephone Number	:	917-494-6287
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2020
Last Update Date	:	05/27/2024

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