Provider Demographics
NPI:1023377702
Name:UNDERWOOD, LAUREN RENEA (BA, MA, LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:RENEA
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:BA, MA, LPC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:RENEA
Other - Last Name:LAMBIASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, MA, LPC
Mailing Address - Street 1:18756 STONE OAK PKWY
Mailing Address - Street 2:STE 220
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258
Mailing Address - Country:US
Mailing Address - Phone:210-789-7683
Mailing Address - Fax:
Practice Address - Street 1:18756 STONE OAK PKWY
Practice Address - Street 2:STE 220
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4790
Practice Address - Country:US
Practice Address - Phone:210-789-7683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66173101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional