Provider Demographics
NPI:1093254823
Name:KARRENBERG, LAUREN (LMFT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:KARRENBERG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 W DIVERSEY AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-1503
Mailing Address - Country:US
Mailing Address - Phone:786-208-1377
Mailing Address - Fax:
Practice Address - Street 1:3111 W DIVERSEY AVE
Practice Address - Street 2:APT 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-1503
Practice Address - Country:US
Practice Address - Phone:786-208-1377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166001113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist