Provider Demographics
NPI:1386224327
Name:DAVIS, LAUREN (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 N MAIN ST STE 330
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3047
Mailing Address - Country:US
Mailing Address - Phone:719-596-7909
Mailing Address - Fax:
Practice Address - Street 1:720 N MAIN ST STE 330
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3047
Practice Address - Country:US
Practice Address - Phone:719-596-7909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health