Provider Demographics
NPI:1194566992
Name:WALTER-ROZELLS, LAUREN ALEXA (MA, AMFT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ALEXA
Last Name:WALTER-ROZELLS
Suffix:
Gender:F
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11347 NEBRASKA AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6714
Mailing Address - Country:US
Mailing Address - Phone:310-570-8202
Mailing Address - Fax:
Practice Address - Street 1:11347 NEBRASKA AVE APT 204
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6714
Practice Address - Country:US
Practice Address - Phone:310-570-8202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146747101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health