Provider Demographics
NPI:1073916367
Name:LAUREN MACK COUNSELING
Entity Type:Organization
Organization Name:LAUREN MACK COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-245-3396
Mailing Address - Street 1:3221 OSCEOLA ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-1778
Mailing Address - Country:US
Mailing Address - Phone:303-842-5544
Mailing Address - Fax:
Practice Address - Street 1:2460 W 26TH AVE
Practice Address - Street 2:BUILDING C, SUITE 165
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5308
Practice Address - Country:US
Practice Address - Phone:720-245-3396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12102251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health