Provider Demographics
NPI:1003033358
Name:TORCH, LAUREN M (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:TORCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 MAIN STREET
Mailing Address - Street 2:SUITE 118 LOWER MIDTOWN MALL
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073
Mailing Address - Country:US
Mailing Address - Phone:207-468-8453
Mailing Address - Fax:207-459-6001
Practice Address - Street 1:890 MAIN STREET
Practice Address - Street 2:SUITE 118 LOWER MIDTOWN MALL
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073
Practice Address - Country:US
Practice Address - Phone:207-468-8453
Practice Address - Fax:207-459-6001
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC124931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical