Provider Demographics
NPI:1083777502
Name:PLOTT, LAUREN ANNE (LISW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANNE
Last Name:PLOTT
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 1:3559 GRIDLEY RD APT 3
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5046
Mailing Address - Country:US
Mailing Address - Phone:216-991-7350
Mailing Address - Fax:
Practice Address - Street 1:13300 AQUILLA RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-7944
Practice Address - Country:US
Practice Address - Phone:440-279-2096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00300051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical