Provider Demographics
NPI:1164295168
Name:WHITEHEAD, LAUREN KAITLIN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:KAITLIN
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 SCRIPTURE ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-4343
Mailing Address - Country:US
Mailing Address - Phone:940-315-7825
Mailing Address - Fax:
Practice Address - Street 1:2660 SCRIPTURE ST STE 210
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4343
Practice Address - Country:US
Practice Address - Phone:940-315-7825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX696341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical