MEDICARE: LAURIE A PERSH LCPC,LPC, CCMHC

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	101YP2500X	Professional Counselor	PRC13708	DC
2	101YP2500X	Professional Counselor	0701005011	VA
3	106H00000X	Marriage & Family Therapist	LMFT000113	DC
4	101YM0800X	Mental Health Counselor	LC0527	MD

General Provider Information

NPI Number	:	1205034436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE A PERSH LCPC,LPC, CCMHC

Provider Business Mailing Address
First Line	:	208 MONTVALE TER
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1223
Country	:	US
Telephone Number	:	443-622-3633
Fax Number	:	301-879-4560

Provider Business Practice Location Address
First Line	:	208 MONTVALE TER
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1223
Country	:	US
Telephone Number	:	301-887-3644
Fax Number	:

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

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	11/10/2019

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