Provider Demographics
NPI:1093568339
Name:HIRSCH, LAUREN ALYSSA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ALYSSA
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 W NORTH AVE APT 727
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-0906
Mailing Address - Country:US
Mailing Address - Phone:503-901-7973
Mailing Address - Fax:
Practice Address - Street 1:1 E WACKER DR STE 3550
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-1845
Practice Address - Country:US
Practice Address - Phone:312-291-9570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist