Provider Demographics
NPI:1316384126
Name:DAMAI, LAUREN (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:DAMAI
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 1:10850 W PARK PL STE 100
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-3636
Mailing Address - Country:US
Mailing Address - Phone:262-789-1191
Mailing Address - Fax:414-359-1191
Practice Address - Street 1:10850 W PARK PL STE 100
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-3636
Practice Address - Country:US
Practice Address - Phone:262-789-1191
Practice Address - Fax:414-359-1191
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI128867-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI128867-121OtherWI DSPS