Provider Demographics
NPI:1376776682
Name:GIBSON-CARTER, LAUREN OLIVIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:OLIVIA
Last Name:GIBSON-CARTER
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 1:3 BARNARD LN
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2452
Mailing Address - Country:US
Mailing Address - Phone:860-874-9995
Mailing Address - Fax:860-578-9143
Practice Address - Street 1:3 BARNARD LN
Practice Address - Street 2:SUITE 107
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2452
Practice Address - Country:US
Practice Address - Phone:860-874-9995
Practice Address - Fax:860-578-9173
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0057841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical