Individual provider Active NPI

Carin Laue, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Los Angeles, CA
National Provider Identifier
1407264609
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY28903 Issued in CA
Practice address
12777 W Jefferson Blvd
Building D, Suite 300
Los Angeles, CA 90066-7048
Phone
(424) 298-2725
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY28903 CA Primary

Addresses

Primary practice location

12777 W Jefferson Blvd
Building D, Suite 300
Los Angeles, CA 90066-7048

Mailing address

12777 W Jefferson Blvd
Building D, Suite 300
Los Angeles, CA 90066-7048
Phone (424) 298-2725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY28903CAMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Acorn Family Guidance Center, a Professional Psychological Corporation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1407264609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12777 W JEFFERSON BLVD",
            "address_2": "BUILDING D, SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667048",
            "telephone_number": "424-298-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12777 W JEFFERSON BLVD",
            "address_2": "BUILDING D, SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667048",
            "telephone_number": "424-298-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUE",
        "first_name": "CARIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY28903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.