Provider Demographics
NPI:1073709234
Name:GIVAN, LAUREN (LISW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GIVAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5515 ROBERT CT
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-1777
Mailing Address - Country:US
Mailing Address - Phone:440-508-6105
Mailing Address - Fax:440-260-8305
Practice Address - Street 1:16101 SNOW RD
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-2817
Practice Address - Country:US
Practice Address - Phone:440-260-8327
Practice Address - Fax:440-260-8305
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801093886104100000X
OHI.15012551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker