Provider Demographics
NPI:1346862919
Name:ADAMS, LAUREN (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:ADAMS
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 1:82163 POCIASK RD
Mailing Address - Street 2:
Mailing Address - City:BUTTERNUT
Mailing Address - State:WI
Mailing Address - Zip Code:54514-9187
Mailing Address - Country:US
Mailing Address - Phone:708-846-8402
Mailing Address - Fax:
Practice Address - Street 1:82163 POCIASK RD
Practice Address - Street 2:
Practice Address - City:BUTTERNUT
Practice Address - State:WI
Practice Address - Zip Code:54514-9187
Practice Address - Country:US
Practice Address - Phone:708-846-8402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-17
Last Update Date:2020-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490214901041C0700X
WI94021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical