Provider Demographics
NPI:1164496394
Name:TANCYUS, LAUREN ELISABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELISABETH
Last Name:TANCYUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:G
Other - Last Name:TANCYUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 1138
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-1138
Mailing Address - Country:US
Mailing Address - Phone:540-688-2646
Mailing Address - Fax:540-668-2656
Practice Address - Street 1:25 MYERS CORNER DR
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-6342
Practice Address - Country:US
Practice Address - Phone:540-688-2646
Practice Address - Fax:540-688-2656
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040030431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA087863OtherOPTIMA BEHAVIORAL
VA2228931OtherFIRST HEALTH
VA1056177OtherCIGNA BEHAVIORAL
VA008936510Medicaid
VA8936510OtherVIRGINIA PREMIER
VA259093OtherANTHEM BEHAVIORAL
VA1056177OtherCIGNA BEHAVIORAL
VA005906A62Medicare ID - Type Unspecified
VA008936510Medicaid
VAC03262Medicare PIN