Provider Demographics
NPI:1164093357
Name:OSTAPOWICZ, LAUREN (BA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:OSTAPOWICZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 JEFFERSON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4207
Mailing Address - Country:US
Mailing Address - Phone:724-288-7633
Mailing Address - Fax:
Practice Address - Street 1:40 ORRS LN
Practice Address - Street 2:
Practice Address - City:TRIADELPHIA
Practice Address - State:WV
Practice Address - Zip Code:26059-1455
Practice Address - Country:US
Practice Address - Phone:304-547-9197
Practice Address - Fax:304-547-9198
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor