Provider Demographics
NPI:1003369232
Name:AMACKER, LAUREN JANZEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:JANZEN
Last Name:AMACKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:JANZEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW
Mailing Address - Street 1:233 WINTON BLOUNT LOOP
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3507
Mailing Address - Country:US
Mailing Address - Phone:334-341-5788
Mailing Address - Fax:
Practice Address - Street 1:233 WINTON BLOUNT LOOP
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3507
Practice Address - Country:US
Practice Address - Phone:334-341-5788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-23
Last Update Date:2016-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3889C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical