Healthcare Provider Details

I. General information

NPI: 1578530846
Provider Name (Legal Business Name): LAURA LYNN FILIP LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 12/09/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N. RAYMOND AVENUE SUITE 604
PASADENA CA
91103-4445
US

IV. Provider business mailing address

30 N. RAYMOND AVENUE SUITE 604
PASADENA CA
91103-4445
US

V. Phone/Fax

Practice location:
  • Phone: 818-395-5463
  • Fax: 818-550-8335
Mailing address:
  • Phone: 818-395-5463
  • Fax: 818-550-8335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCS21338
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS21338
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: