Provider Demographics
NPI:1679608939
Name:MONCRIEF, LAURIE (MFCC)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:MONCRIEF
Suffix:
Gender:F
Credentials:MFCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16480 HARBOR BLVD
Mailing Address - Street 2:#104
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1361
Mailing Address - Country:US
Mailing Address - Phone:714-899-4005
Mailing Address - Fax:714-899-4275
Practice Address - Street 1:16480 HARBOR BLVD
Practice Address - Street 2:#104
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1361
Practice Address - Country:US
Practice Address - Phone:714-899-4005
Practice Address - Fax:714-899-4275
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC12680101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health