Provider Demographics
NPI:1225276322
Name:REITER, LAUREN JEAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:JEAN
Last Name:REITER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 LARAMIE DR
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-7221
Mailing Address - Country:US
Mailing Address - Phone:817-326-4067
Mailing Address - Fax:
Practice Address - Street 1:3910 LARAMIE DR
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-7221
Practice Address - Country:US
Practice Address - Phone:817-326-4067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX385661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical