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General NPI Number Information
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NPI Number | 1730718917
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Entity Type | Individual
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Provider Name | LAURA BARONE LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 1107 OCEAN PARK BLVD APT B
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City | SANTA MONICA
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State | CA
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Zip | 90405-4793
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Country | US
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Telephone | 917-494-6287
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Fax |
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Provider Business Mailing Address
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Address Line | 313 GRAND BLVD PO BOX 1222
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City | VENICE
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State | CA
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Zip | 90291-2306
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Country | US
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Telephone | 917-494-6287
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW120782
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 91594
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License Number State | CA
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