Provider Demographics
NPI:1427461318
Name:KUSHNER, LAURA
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:KUSHNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8710 CAMERON ST
Mailing Address - Street 2:UNIT 1023
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3703
Mailing Address - Country:US
Mailing Address - Phone:410-610-2901
Mailing Address - Fax:
Practice Address - Street 1:1634 EYE ST NW
Practice Address - Street 2:SUITE 700
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-4003
Practice Address - Country:US
Practice Address - Phone:202-888-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000975103TC0700X
MD05064103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical